Remote Individualized Coaching Questionnaire

PERFORMANCE TRAINING QUESTIONNAIRE

Thanks for your interest in Sean Cochran’s Online Remote Individualized Coaching program. Sean is accepting a limited number of clients currently. To get started with your application, we need to learn a little more about you. Please follow the instructions and fill out the form below. Sean will review the information provided and schedule a virtual call as your next step.

Individualized Remote Coaching is $249 per month (30-day email cancelation required).

Personal Information

First Name *
Last Name *
Email *
Age *
Gender *
FemaleMale
Occupation
Current Location (City / State / Country)

Training History

Describe your overall training history: *
Briefly describe your training over the last 4-6 weeks (if different from above): *
Have you worked with an in-person coach / trainer in the past?* *
YesNo
If yes to either of the above, why did you stop working with the above coach(es)? *

Injury History

Do you have any past medical history that may impact your ability to exercise? If so, please explain:* *
Describe your injury history. Be as specific as possible: *
Are you currently suffering from any injuries that may limit your training? If yes, please explain:
Have you been cleared by your doctor to begin an exercise program? *
YesNo

Goals

Describe your fitness goals. What do you want to achieve the most? Be specific: *
Why do you want to achieve these goals? What will reaching these goals help you achieve?
What has stopped you from achieving these goals in the past?*

Additional Information

How many days per week do you ideally want to train? *
How many minutes per training session do you typically have to workout? *
What sort of gym do you work out in? *
What (if any) are the equipment limitations of your gym? NO access to barbells, dumbbells, kettlebells, TRX, Medicine Balls, Sleds, Ropes, Bikes, Rowers, etc. (please be specific)
What equipment do you have available for your workouts (please be specific)?
Do you take part in any recreational activities (golf, tennis, skiing, etc.)?

Verification

Please enter any two digits *Example: 12
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