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Coaching
Free Resources
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About Me
Contact

Application Form

Please fill out all the fields to the best of your ability. Once you submit the form, and if I think you’re a good fit, then I’ll email you within 2-4 days. If you have any questions about any of the items in this form, please send them to newton@newtonkwong.net and I’ll get back to you ASAP!

Name *

First

Last

Email *

Date of Birth *

Sex *

Male
Female

Height *

Weight *

Which is better: Marvel or DC? *

Marvel
DC
Star Wars is better than both of them!
Hmm...I think I've heard of them before? *shrug*

What are your health and fitness goals? *

Try to be as specific as you can. A few sentences will do!

What time frame would you like to achieve them in? *

Very Quickly (1-3 months)
Fairly Soon (4-6 months)
I've Got Some Time (7-12 months)
Long Term Lifestyle (12+ months)

What are the usual challenges and obstacles you face when trying to achieve these goals? *

What workout programs and diets have you tried before? *

Which ones worked? Which ones didn't?

During the last 3 months, how often did you prepare your own meals? *

Daily
Most days
Some days
Rarely
Never

What would a typical meal for you consist of? *

You can be pretty general about it for now. We'll have time later on to get into more specifics.

What's your favorite pump up music? *

During the last 3 months, how many workouts did you do per week? *

0
1-2
3-4
Over 5

I define workouts as being intentional physical activity that moves you closer towards your goal. Something as simple as a planned 20 minute walk to get in extra steps counts. You can provide more detail in the next question.

What kind of workouts were they? *

Examples: Walking, Gym workouts, Home workouts, Online videos, Outdoor activities, Fitness classes, etc.

Do you have a favorite sports team(s)? *

During the last 3 months, how much sleep did you get on a typical night? *

Under 4 hours
5-6 hours
7-8 hours
Over 8 hours

During the last 3 months, how much free time did you have on a typical day? *

None I'm so busy!
1-2 hours
3-4 hours
Over 5 hours

Don't worry...I won't tell your boss!

Do you have any health or medical issues that I should know about? If yes, then please explain. *

Have you ever had a trainer or a coach before? *

Yes
No

How do you think my coaching will help you? *

I want to get an idea of what you need from me. We'll nail this down with more specificity as we work together.

Is there anyone else involved in your decision-making process for hiring a coach and going on a nutrition and exercise program? *

Example: Spouse/Partner, Parents, etc.

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