Client Application Form

This form allows me to get background information on where you currently stand, where you'd like to go from there and what changes will need to be made going forward.

Carefully take the time to read all the questions and give the most detailed answers possible.

If questions are not properly answered I will ask you to resubmit this form.

This form will present you with the opportunity to understand my expectations from you as well as what you can expect from me.

If spots are limited and I receive a lot of applications I will have to settle for the client who pays first.

If we do not end up being a good fit or I run out of spots I will refer you to another coach.
Upon receiving and approving this form I will reach out to you to arrange a phone consultation.

Full Name*

First NameLast Name

Phone Number(for Whatsapp or Telegram)*

E-mail*

example@example.com

How did you hear about me?*

Age and Gender*

Current weight and height?*

Country you reside in(leave blank if your in Canada)

How long have you been training?(Leave as 0 if it's under a year)*

At what level is your current training?*

True BeginnerBeginner-Intermediate(under a year experience)IntermediateAdvanced

What is your current training regime (paste your current one or type up the exercises you do with reps and sets), how often do you train and for how long:*

Upload your Current training plan here if it is already written.

Do you do cardio or other sports? Specify what kind and the frequency*

List your current goals using the SMART acronym(specific, measurable, attainable, realistic, time)*

What days can you train?(Do not tick off the day if you can't commit at least an hour)*

Where will you be training?*

Home GymRecreational Center or School GymCommercial Gym

List the foods you currently eat on a regular basis/enjoy*

Foods that are off the menu!*

Do you have any of the following?:*

Are you recovering from any injuries/previous illness ?- Please specify if yes*

What is your current schedule like( Work, sleep, training, etc)*

Are you on any Prescribed medication or use recreational drugs? - Please Specify*

List all supplements you take( be it vitamins, minerals, PEDs)*

Do you own a food scale and are willing to meal prep?*

Are you able to weigh yourself weekly?*

Progress pictures will expected from you every week on check-ins. Upload 4 relaxed full body pictures( one from the front, each side, and back). Ideally you should only be wearing underwear/undergarments. *These will not be shared to anyone but myself.**

Which plan interests you? - Prices are in Canadian Dollars**

Basic Plan($200/month)Premium Plan($275/month)Ultimate Plan($350/month)Diamond Plan($450/month)

Finally, feel free to leave any other relevant information or drop some questions for me so that I can answer them in our scheduled phone consultation.

Disclaimer: I am not a doctor or dietitician and the information provided should not be taken as medical advice. These are only recommendations. These recommendations should NOT be taken as medical advice, nor are they intended to diagnose, treat, cure, or prevent any health problem. This is not intended to replace the advice of a physician or health professional. Before beginning any diet or exercise program, please consult your physician or a health professional. I take your privacy seriously and will not share photos or client information without your explicit consent.

Do not hesitate to contact me on Instagram or at K.M.coaching33@gmail.com if there's any clarity needed about any of these questions.

Once you have completed and signed this form, I will review it and contact you within 48 hours to schedule a phone consultation.

Signature

Kian Mokhtarian, Fitness and Bodybuilding Coach