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COACHING INTAKE FORM

First Name

Last Name

Phone

Email Address

What are your specific fitness goals? *

I want to lose fat

I want to gain muscle

I want to maintain

Other (provide details below)

If other, be specific

How often do work out per week? This can be any training involving weights bodyweight. *

Once per week

2 times per week

3 times per week

4 times per week

5 times per week

6-7 times per week

None

When are you looking to start training? How many days per week?

Do you have any existing medical conditions, health concerns, injuries or physical limitations that may affect your exercise routine?

On a scale of 1 to 10, how motivated are you to make changes to improve your health?

Have you previously worked with a health coach or wellness professional? If yes, please describe your experience.

Consultation Preference * Required

Phone call

Video Call

Thanks for submitting!

Get in touch

First name*

Last name

Position*

Company name*

Number of Employees*

Phone*

Email*

Write a message

CLIENT EXPERIENCES

Meaningful change. Lasting Results

"Working with Misha has been a joy. I lost 18 pounds so far and feel better than ever. My only regret is that I did not find her earlier lol!" —Jessica M.

"I can't believe how far I've come. Not only have I lost weight, but I feel stronger and more confident than ever. I feel like me again. Misha is encouraging, supportive and a wealth of knowledge." —Amanda C.

"I completed the Accountability Partnership Program with Misha and ended up doing three rounds of the program. The accountability helped me stay focused while studying for the LSAT, even when life got busy. Having someone to check in with, keep me accountable, and support me through challenges made a huge difference." — Shanice

"I never lifted weights in my life. Honestly, I was scared of them. Misharé encouraged me to step outside my comfort zone and gave me the confidence to start. The changes went far beyond my body—I feel stronger, more confident, and have a completely different outlook on what I'm capable of. I started this journey after 45, and I can't thank Misha enough."— Lucinda R.

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About
Coaching
Resources
- 6-Week Strength Guide
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