Please be aware – Not everyone is accepted for this program. Nothing personal, but I am very protective of my inner circle.
Your Name (required)
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1. Please list out your goals, be as detailed as possible.
2. Ok... now be honest with yourself, WHY do you believe you're not at your desired goal right now? *
3. On a scale of 1-10 how do your feel about your body right now? (10 being you would run down the street naked.) *
4. On a scale of 1-10 what are your energy levels right now? (1 being you can't get out of bed.) *
5. What made you fill out this form today? Why now? Please be as detailed as possible. (Had enough, seen our results, frustrated with lack of progress, etc.) *
6. What qualities are you looking for in a weight loss program? *
Sustainable weight loss and toningSupport and guidance from a qualified, competent fitness coachSupport from a group of like-minded folks helping each otherNon-intimidating environmentEasy-to-follow meal plan that allows me to enjoy my favorite foodsPeople asking if I've lost weightall of the above
7. Have you ever worked with a fitness coach before? *
8. Why Russ Sherman and not one of the cheap pay-as-you-go fitness options? *
9. I'm very selective about who I let in our programs... Why should I choose you?
10. If personal training had to be a part of your monthly budget what amount would you be comfortable spending?
Between $100 and $199Between $200 and $399Whatever it takes if the fit is right for meI'll never waste money on a personal trainer
11. Finally, which one best describes you? *
Excuse-maker that's always looking for a magic pillProcrastinator that's always putting things offAn action-taker that's ready to make changes NOW
Lastly,I have filled out the form to the best of my ability. By checking this box I certify that I am truly interested in changing my life.