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My coaching is personalized, so be as detailed as possible in your responses.

Full Name? *

Email Address? *

Phone Number? *

What is your Instagram? *

Age? *

Height? *

Weight? *

How did you hear about Kurt Rawlins Fitness? *

What do you do for work (this is for research purposes only)? *

What is your #1 goal? *

Please be as specific as possible.

Why is NOW the time you have decided to fix this? *

Why not just do it on your own? Why are you seeking our help? *

Please describe your current diet/exercise/weight situation... *

What have you tried to reach your goals? *

What is the ONE thing you'd like to get out of this program? *

Why do you want to work with me and what makes you a good fit for this program? *

Is there anything about you that you think could give us a better idea of your journey thus far and what your ultimate goals are? *

Where would you like to be health/mindset/bodywise in 12 months? *

What is your experience with strength training? Are you well-versed in squatting, lunging, deadlifting, bench pressing, rowing and/or pull ups? *

Do you need permission from your spouse/partner to make a financial decision? *

Yes, I can't make financial decisions without my partner

No, I do not. I make my own financial decisions if it is something I want or need to do

If you answered above that you make your own financial decisions then this means you are able to make a financial decision on the day of the call without running the decision by anyone else, correct? *

Yes

No

Are you a person of integrity who will show up for your SCHEDULED call? I value my time and respect yours. PLEASE do your best not to cancel, it is RARE that I allow reschedules! *

YES I WILL SHOW UP! There is no way in the world I would miss this call with you!

NO, I'm a pretty flakey individual. I may make it. I may not. Who knows?

It is extremely CRUCIAL during this call that you are in a QUIET space with NO distractions for 30-45 mins. Make sure you are NOT driving, at work, or around a crowd. Does that work for you? *

I understand! I will be in a quiet space.

No I cannot proceed.

This will be a video call as I would like to get a clear understanding of your goals and see if I can help you. We will meet using the Zoom link provided to you once you book your call. *

That works for me.

That doesn't work for me.

My program is not free, or cheap, but it IS affordable for people who are serious about transforming their health. What are you willing to INVEST TODAY for GUARANTEED PERMANENT RESULTS? *

$$ Transforming my health is semi-important to me

$$$ Transforming my health is really important to me

$$$$ I HAVE to transform my health NOW and I am willing to do whatever it takes

***IMPORTANT - PLEASE READ

This is an opportunity to join the Best Selling - Leaner For Life VIP 1-1 Online Coaching Program.

If you are accepted, you will be done with:

* Fad Diets

* Crash Diets

* Juice Cleanses

* Yo-Yo Dieting

* No Sugar/No Bread Restrictions

You will join a community of LIKE-MINDED women who were once exactly where you are - stuck, frustrated and unsure where to go next.

You can be sure of this - if you are willing put in your best effort, I GUARANTEE my program will work for you. And I back that up with a full 30-day money-back guarantee if you are unsatisfied in any way.

You will lose weight, tone up and finally start to feel more comfortable in your own skin again. The good news? You can do this including pizza, wine and chocolate. Zero restrictions here. NONE. I've helped over 1000 women achieve their best body and live their best lives. I want you to be next.

Now, because we only accept women are truly READY to make a change, we need to make sure you are the right fit. You need to be ready to MAKE A DECISION and stop "thinking about it" or waiting for the perfect time (it NEVER happens).

If accepted into my program, are you ready and willing to make a financial and time commitment NOW to finally shedding the fat, gaining strength and fitting back into your favorite clothes? *

Yes

No