YAY Let’s get going girl!

please fill out the form and submit it so that I can get working on your custom training plan. Please note this can take up to 5 working days, but I will be in touch as soon as it is ready.

One-off Custom Plan Form

Name *

First

Last

Email *

Please double check this to ensure it is correct

Phone *

Date of Birth *

Age *

Height (cm) *

Current Weight (kg) *

Is this your first time working with us? *

How did you find out about this program? *

A referral by friend or family member
Social media
Other

EXERCISE

Experience level *

Just Starting Now
Moderate - have followed a program before
Advanced

Please tell me about your past training experience? *

What are your current goals? *

Fat loss
Muscle gain
Overall health and fitness

You can only select ONE option as this will determine how we develop your training plans (you can elaborate below)

What are your short term training goals? *

What are your long term training goals? *

How many training sessions per week would you like us to create? *

We recommend 3-5 sessions per week

Injuries that may affect training plans? *

Do you feel faint or dizzy when exercising? *

Are you on any prescribed medications? Please list them below *

CURRENT TRAINING

Do you currently undergo any type of fitness training, if so how often? (Choose one) *

I currently don’t train
Yes I train 1-2x per week
Yes I train 3-5x per week
Yes I train 6+ x per week

What type of training are you currently doing and how often/long ? (Be specific EG- Running 2x 30 mins, Yoga 1x , Weights 3x) *

Please be specific as this will help us build the best plan to fit into your lifestyle.

What is your current daily activity levels? Choose One: *

Sedentary (Office job) Less than 5000 steps per day
Moderately Active (Teacher, retails etc 5000-8000 Steps per day )
Active (Hospitality, manual labour etc 8000-10000 steps per day.
Very Active 12000 + Steps per day

Do you want a home training plan or gym training plan? *

Home training plan
Gym training plan

If you are wanting a home training plan please list equipment in detail below.

The more detail the better as this is a One- Off Plan

Do you have specific areas you would like to work more on? *

Is there anything else you think we need to know to create the best one-off plan for you ? *

I understand I should get full doctors clearance before starting my Training plan with Jess Coate Fitness *

I understand my turn around time for my plan is 5 working days *

File Upload

Click or drag files to this area to upload. You can upload up to 5 files.

Lastly if you would like to send pics front side and back along with this info it may help me more with how I will prescribe the exercise.

YAY Let’s get going girl!

One-off Custom Plan Form

EXERCISE

CURRENT TRAINING

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