Just to confirm, you’re a lifter who is motivated to solve your pain/injury and get back to training confidently?
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Yes
No
Full Name
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Phone
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Email
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What injuries/pains are you struggling with?
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Back Pain
Shoulder Pain
Knee Pain
Hip Pain
Elbow Pain
Other
On a scale of 0-5 (0=not important at all, 5=incredibly important), how important is it for you to solve your pain/injury?
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0
1
2
3
4
5
Why did you choose the number that you chose in the last question?
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Where have you been getting stuck when trying to solve this?
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Unsure of what rehab work to do
Don't know how to modify my training
Need accountability
Other
What is your age?
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18-24
25-34
35-44
45+
What have you already tried doing to solve this?
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Traditional PT
Chiropractic
Rest
Self-rehab
Other
How does your injury impact your life outside of the gym (mentally, emotionally etc)?
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If you are accepted, how soon would you want to get started?
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Immediately
Within a month from now
Over a month from now
If you found a program that was exactly what you are looking for, are you in a place in your life where you are able to make a financial and time investment towards solving your injury and getting back to the training you want to be doing?
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Yes
No
If we decide that coaching is a good fit, would you be making that decision alone, or do you have a significant other who would be helping?
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Yup, it’s all up to me!
No, my partner would need to be a part of the decision
How did you hear about this coaching program?
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Submit