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Online 1-on-1 Coaching

LKR 10,000 / month · Full coaching with daily check-ins

Hey there, thank you for choosing online coaching. Please fill out this form honestly so I can understand your goals, lifestyle, and training background before we get started.

Please read before filling in: Submitting this form does not confirm your place. After reviewing your answers, I'll contact you with payment details. Your program will only be created after payment is completed. Personalized plans are non-refundable once prepared.

Section 1

Physical Activity Readiness (PAR-Q)

If you answer Yes to any question below, consult your doctor before starting this plan.

Has a doctor ever said you have a heart condition and that you should only do physical activity recommended by a doctor? *

Do you feel pain in your chest when you do physical activity? *

In the past month, have you had chest pain when you were not doing physical activity? *

Do you lose your balance from dizziness or ever lose consciousness? *

Do you have a bone or joint problem that could get worse with exercise (e.g. arthritis, recent surgery, or an injury)? *

Is your doctor currently prescribing medication for your blood pressure or heart condition? *

Do you know of any other reason you should not exercise? *

Section 2

Personal Information

Section 3

Current Health & Medical History

Do you currently have any medical conditions or injuries? (e.g. heart disease, diabetes, asthma, joint problems, back pain, high blood pressure) *

Are you currently taking any medications? *

Have you had any recent surgeries or hospitalizations in the past 12 months? *

Do you experience dizziness, chest pain, shortness of breath, or severe joint pain during or after exercise? *

Are you pregnant or have you given birth in the last 3 months? *

Do you have any allergies or special dietary restrictions? *

Section 4

Lifestyle & Habits

Section 5

Training & Exercise Experience

Have you worked with a personal trainer or coach before? *

Section 6

Goals & Motivation

Section 7

Consent & Acknowledgement

After submitting, I'll contact you on WhatsApp within 24 hours with payment details.

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Application Received!

Thank you for applying for 1-on-1 Coaching. I'll review your application and get in touch on WhatsApp within 24 hours to discuss next steps and payment.

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