Online Coaching Application Form

Personal Information

First name

Last name

Phone

Birthday

Month

Day

Year

About You

Tell me a bit about yourself and your lifestyle: (e.g., work/family routine, weekly commitments, anything you feel is relevant)

What made you want to apply for 1:2:1 coaching? (What are you hoping to achieve?)

What are your biggest struggles when it comes to your health and wellness right now?

Have you worked with a coach or followed any fitness/nutrition plans before? If yes, what was your experience like?

What does a typical week of movement/exercise look like for you currently?

Do you currently have access to a gym or any equipment at home? (If yes, please list what you have available.)

Health & Wellbeing

Do you have any current or past injuries I should be aware of?

Are you pregnant, postpartum, or trying to conceive?

Do you have any diagnosed medical conditions? (e.g., PCOS, thyroid conditions, autoimmune issues, etc.)

Are you currently taking any medication?

Coaching Fit

On a scale of 1–10, how committed are you to making changes to your lifestyle right now?

Are you ready to take ownership, stay accountable, and receive honest support and feedback throughout your journey?

Yes, I’m all in!

I think so, but I’m a little nervous

Not sure yet — I’d like to chat more

Next Steps

Once submitted, Ellie will review your application and be in touch within 48 hours. If it feels like the right fit on both sides, you'll be invited to book a call to start your tailored 1:2:1 journey!