Intake Form

Thank you for your interest in working with Fit & Fearless Nutrition and Coaching LLC! It is crucial that you fill out this form with as much detail as possible so I can best serve you when we chat!

What is your first & last name? *

What is your email? *

Cell phone number? *

How old are you? *

What is your IG Handle?
*

What are the health and fitness goals you are trying to accomplish? *

I want to lose fat (lose weight)

I want to build muscle (gain weight)

Improve Performance (strength, endurance, etc.)

I want to improve my overall health, increase energy, etc.

Required

Which best describes your nutrition for the last 30 days?
*

I track my meals or macros

I follow a meal plan

I have tracked in the past, but not currently

I have never tracked

What has been your biggest challenge to reaching your goals?
*

On a scale of 1-5, how ready are you to make this goal a reality? (1 being not ready and 5 being very ready?)
*

Are you in a position where you can invest in yourself and your health?
*

Yes

Anything else we should know? *

Are you excited?!? *

Hell yes

Yes

Of course

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