PPSC Coaching Application Dr John Rusin

Name

Phone Number

Email Address

What's your home address?

What is your date of birth?

What is your Instagram handle? (Example @painfreetraining)

What is your primary health, fitness or performance goal?

Are you currently exercising free of pain or limitation?

Yes

No

What have your last 3 months of training looked like?

What's your biggest challenge to achieve your goal?

What's been your biggest victory in your health & fitness?

What does success with your health and fitness look and feel like?

What was the driving factor for applying to work with me as your coach?

Are you currently in a position financially to invest in an online coach?

Yes, I am financially able to hire an online coach.

No, but I will figure out a way to make it work because health is my priority.

No, I'm currently not able to financially invest in a personal online coach at this time.

Anything else you'd like to tell me about yourself?

Book your FREE consult call on the next page before exiting this form.

YES! I will submit my application, wait a few seconds to see a link for schedule and book it!

No... I am not interested in doing a FREE consult call about my coaching application.

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