Application for Coaching

YESSS!!! Let's do this thing! We are excited for your journey and commend you for your initiative.

At this time, EMPOWER Health and Fitness, LLC is only accepting applications from those who are serious, committed, and ready to make a decision to change their life.

If you are just price shopping please do not fill out this application.

Congrats on making a huge step to leveling up your mindset and physique! We understand that investing in yourself can be a little scary. It's okay to be nervous, scared, or anxious!

1:1 Coaching Services include:

-Custom training and cardio for your individual needs, injury history, and goals.

-Nutrition to fit your individual goals, lifestyle, and create habits that make for awesome, sustainable results.

-All plans come with weekly accountability.

ARE YOU READY?

What is your first and last name? *

What is your email? *

What is your phone number? *

(NOTE: This helps us to confirm your Zoom Call with our team by text. Please make sure your phone is "NOT" on do not disturb mode or blocking unknown numbers or we will be unable to contact you 😊 )

What is your Instagram handle (name) *

How long have you followed us? *

Less than 6 months

More than 6 months, but less than a year

More than 1 year

Were you referred to us by someone? *

If so, please provide their first and last name.

Why Empower Health and Fitness? *

How serious and dedicated are you to overcoming your struggles and putting in the effort? *

(1 being NOT at all dedicated and 5 meaning VERY dedicated)

Have you ever had TRUE 1:1 coaching before? *

Yes

(NOT 1 Phorm, Beach Body, Ozempic Coaching, Trainer at the gym, ect)

Why is NOW the time to work towards it and not later? *

What have you tried in the past to reach this goal? Be specific! *

If you took action right now, where do you see yourself in 6 months? *

What is holding you back from achieving your goal? *

(Something is...because if there wasn't, you would have already achieved it on your own)

What are the top 3-5 things you spend money on that don't contribute to your health and fitness goals ? *

***Please do NOT include living expenses (ex: rent, gas, loans, bills, etc)

How much does all of that cost per month? (Estimate if you don't know the exact amount) *

Please do NOT include living expenses (ex: rent, gas, loans, bills, etc)

Does your spouse or significant other support you? (meaning they will give you a thumbs up on whatever you decide) *

Yes

Not applicable

Will you need any one else involved in the financial decision making? (totally cool if so, we do joint calls!) *

Yes

Are you willing to dedicate 3-4 hours/week to your health? *

Yes

We offer many different payment options and terms, and we’ll work with you individually to find the best fit for your goals and budget.

To respect both of our time, we like to eliminate “I need to think about it” by keeping things simple and clear.

By the end of our 45–60 minute call — after we’ve identified your goals, detailed the program, and reviewed the investment — are you comfortable committing to one of these three decisions?

1️⃣ Yes: This feels like the right fit and I’m ready to move forward.
2️⃣ Yes, but: I want to move forward and we’ll collaborate on the best payment option.
3️⃣ No: This isn’t the right fit for me right now.

This question is required.

If accepted, how soon are you looking to get started?

If you’re not ready to begin right away, that’s totally okay — we’d encourage you to wait and schedule when the timing feels right.

For those who feel this is the right fit, our expectation is that we’ll be able to move forward and pinpoint a clear start date together at the end of your call. *

For the Zoom, I agree I will be in a place where I can be fully attentive — not multitasking, working, driving, or distracted. I will make sure I am present and focused so I can get the most out of the call *

Yes

I realize I am booking a real-time call with Coach Jen or a member of the Empower team.

I understand the Empower team has families, businesses, and friends just like me, and I value their time as much as my own.

By scheduling, I agree that I will:

✅ Show up at the exact date and time I select.
✅ Treat this as a real-time appointment, just like I would for work, family, or personal obligations.
✅ Only schedule a time I can fully commit to.

👉 We believe you’re a person of integrity who respects our time in return.

Do you agree to this commitment? *

Yes

I realize that I will be paired 1:1 with Coach Jen OR another one of Empower's amazing Coaches on staff. The coach is chosen based on personality, your goals, and your challenges. *

Yes

Investing in yourself (time, energy, financially) is a declaration in saying that you are worth developing and improving. Are you in a position where you can invest? *

I have the finances/energy to invest in my personal growth, knowledge, and health.

I am willing to invest if I believe the program and accountability can deliver results.

I am not in a position where I can invest in my personal growth, health, or physique at this time.

Do you give consent to have your Consultation Call recorded for Quality and Training purposes? *

I accept

I don't accept

Client Transformations