MMM Coaching Application

First Name *

Last Name *

Email *

Phone *

What are your wellness goals for the next 3-6 months? Why are these goals important to you? Be very specific, the more detail the better! *

Current Weight *

Age *

Height *

If someone referred you, who was it? *

How did you hear about Katalyst Fitness and Nutrition? *

Have you counted macros or calories before? If so, how many calories are you eating right now? *

What is your specific weight loss goal? *

Are you interested in rapid fat loss? *

Would you be more motivated by losing 3-5 lbs per week? *

Would you be motivated to lose 5-8 lbs in 2 weeks? *

Current workout routine & nutrition (food types, # * of meals per day cardio, lifting... and how many days/minutes per week...honesty please)? *

What past diets have you done? When was your last diet? *

Do you have an injuries (past and present) or surgeries/health conditions to note (i.e. PCOS, gastric bypass, hysterectomy, hypothyroidism, HRT, IBS, etc.) *

Does your spouse or significant other support you? (Meaning they will give you a thumbs up on whatever you decide)” - If you're single, or like "I don't need permission" - Just answer yes ;) *

Why do you want to work with Katalyst Fitness & Nutrition? *

What is your biggest hurdle when it comes to reaching your goals AND why do you want to make a change now? *

I agree to terms & conditions provided by Katalyst Fitness & Nutrition. By providing my phone number, I agree to receive text messages from Katalyst Fitness & Nutrition.

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