Get Customized Fitness & Nutrition Plan

Please fill in the form below and be honest. All your info will be kept confidential and won’t be shared with anyone. The more I know about you, the better advice and recommendations I can provide. Make sure that you’ve beforehand.

Before proceeding, please make sure that:

1)      You’re of legal age, 18 years old and above

2)      You’re a resident of USA, Canada, or US Territories

3)      You’re not coached by other Independent Team Beachbody Coaches

Also, after submitting, please send your current picture to my email rippedlikenick@gmail.com. For guys, please take one shirtless, standing front pose, or do a flex pose. For girls, please wear tight fitting clothes or workout clothes.

THIS IS ONLY FOR MY CUSTOMERS/COACHEES.

You can appoint me as your Team Beachbody Coach here. If you have a a registered coach with someone else, and still want to be coached my me, send me a private email and we can discuss whether we’re a good fit.

Sample Pose for Front, Angle-Side, Flex

Name
Email
Age
Height (in ft and inches)
Phone (preferably cell)
Weight (in lbs)
Location (City, State)
What BEACHBODY workout program do you plan to do or currently doing? When is your start date or planning to start? If you're unsure, please describe what you like to do for working out so that I could recommend the best program for you.
What is your workout goal? To lose how many lbs? To add how many lbs of lean muscle mass? What is the time frame.
Why do you decide to improve your health, and/or to transform your body. I'd love to hear your reasons and your WHY
What do you do for a living? How much time per day do you spend at work? Please describe in detail on what you do at work. For example, if you’re a carpenter, explain that you do manual labor all day long, etc.
Do you have any workout equipment at home? Please describe in details. For example, if you do have a set of dumbbells, please describe the brand and what weights you have – 10, 15, 20 25 lbs…etc
Describe your current fitness level and what you do to stay active.
Do you have a gym membership or have access to a workout facility?
Do you take any supplements? What kind? List down the name and brand
How is your diet? Do you eat out all the time or do you cook at home most of the time? Do you drink alcoholic beverages or sodas?
What is your budget for supplements? How much are you willing to invest per month on repairing and recovering your body? (Please do not write 'no budget' without explaining it)
What is your biggest challenge in transforming your body? Time? Commitment? Discipline?
Please write any additional information that I should be aware about (maybe injuries, allergies?)