Pre-consult Form

Pre-consultation Form

Please take a few minutes to answer the questions below and pick a time on the next page.

First Name

Last Name

Age

Where do you live?

City & Country

What is your occupation?

What do you do for work? Or do you have your own business?

What is your current fitness situation?

Please be specific

What is your dream goal?

Please be specific

How long with it take to accomplish your goal on your own?

Do you want to sustain your goal after you achieved it?

How long have you wanted to achieve your goal?

Why do you want to achieve your goal so badly?

Please be specific

You already know it's not easy to achieve your goal, would you take our recommendations and do what we ask in order to reach your goal?

Why are you applying now?

Why is it important to achieve your goal now? Please be specific.

Why do you think you will succeed this time?

Our average client loses 15 lbs or more with us in the first 3 months, are you okay with this?

What is your current state?

Height, Weight, Body Fat, Health Conditions, etc.

What is your desired state?

Weight, Body Fat, Health Conditions, etc.

Have you struggled to lose weight in the past?

Have you struggled with maintaining a self directed fitness program in the past?

Do you think you will lose weight faster with an expert coaching you along the way?

Do you think you will lose weight faster with daily accountability?

Is it more important that you lose weight quick or that is permanent?

Why do you want to work with Amir?

What makes you a good fit for this program?

If your desired goals and results from this program were guaranteed, what level of service are you considering investing in?

If accepted, how soon are you looking to get started?

If you are not ready please just wait and schedule when you ready.

How did you hear about coach Amir?

If you heard about Coach Amir through a friend, what is your friend's name?