First Name *

Last Name *

Email *

Phone

1- Are you READY to get in control or level up your health and fitness? *

YES

This is what I do so just want to make sure :)

2- What body type are you at the moment? *

Skinny - need to add some tone

Skinny Fat - I am in a soft fluffy middle ground

Medium - I look fairly normal I would say

Chubby - I am soft around the edges

Obese - I am overweight

Bottom heavy - Top is toned but legs are not

Top heavy - Legs are toned but upper body is not

Prefer not to answer

(Please select all that apply)

4- Do you have any experience with macronutrients? *

Advanced

I know a thing or two

Beginner

Tried and didn't work

5- MACROS Macronutrients are an overall approach to food that when used correctly gives you immense control over your body composition!

BENEFITS (macros)

6- Which of the following describes your current situation the best? *

I am trying really really hard with my workouts and nutrition, but I cant get toned. No matter what I do, I still have a soft fluffy look.

I have no idea any more when it comes to my nutrition. Everywhere you go, someone is saying something different. I have no problem putting in the work... I just want to know I am doing the right thing.

I was out of shape, and began to make progress, and now my results have stopped and it's become disheartening. I don't want to fall out of shape again but its becoming hard for me to keep pushing forward when I'm no longer seeing results

I am using macros, this flexible framework is so intriguing to me, and they have helped me progress. But I am seeing now that there might be more to this than I was aware of... and I want answers!

Food controls ME. I am so unsure about what I should be eating, and if I am doing the right thing, that every morning when I wake up, I feel a sense of worry. This is unhealthy and I want to fix it.

I have been out of shape for quite some time. I need a full REBOOT. I need you to believe in me because I am not sure I do anymore.

I feel like I am already in pretty good shape. I just want to take things to the next level. I have pushed my experience to the limits of where it can take me and am looking for more!

I am really uncomfortable in my skin, and it's beginning to wear down my confidence levels, and is starting to have a downward impact on other areas of my life.

Other

Please select all that apply to you.

7- How committed are you to solve this problem today? *

5/10 - I don't want to improve my situation that much and am OK not making more progress than I have now.

7/10 - I am pretty frustrated with things right now, and want to get them sorted... the sooner the better.

9/10 - This is affecting my confidence, energy, and how I am showing up in life. I want to fix ASAP!

10/10 - I will literally do anything to get this situated, I do not want to go on one day longer without sustainable, long term program that will improve my health habits, body composition and mindset!

8- Where would you like to be 6-12 months from now? *

I want to feel like I am in control of my food and my body.

I want to feel free from food and the mental chatter that comes with not understanding it.

I want to feel like I can do this myself, and am not dependent on a trainer/nutritionist forever.

I want to drop 10-15 lbs of fat

I want to drop 20+ lbs of fat

I want to add lean muscle tone

I want to live a healthy lifestyle that deserves respect.

Other

Please select all that apply to you.

9- What is holding you back from achieving these goals? *

I have a hard time sticking to a diet... I think because I have a hard time believing it will work long term.

I can stick to a diet, they just always stop working after a certain point, and then I quit them.

I have no problem putting int the work, I just am not sure on what I am supposed to do!

I have trouble trusting the process and need something full proof that I can understand myself.

I don't have the knowledge. The confusion is causing inaction and I am done with it.

I have a hard time committing and need a heavy element of accountability & support.

I don't have a community or people around me who think like me and can support me.

I don't have any expert coaches, or advice that helps me get back on track.

Please select all that apply to you.

10- Please Share any other things you think are your big obstacles holding you back from your Health and Fitness Goals. *

11- What are the most important goals you want to reach with your health and fitness? And please explain why you need Coach Dom's help. *

13- Are you prepared to take action RIGHT NOW to invest significant time, energy, and finances in yourself to reach your goals if you knew with 100% certainty that you would get there? *

Yes, absolutely!

No, I am not ready.

14- If you're accepted into the Tribe's program, how soon can you get started? *

15- Where did you hear about Tribe Fitness Online? *

Facebook

Instagram

Referral

16- Age *Enter age above

17- What is your height? *Feet and Inches

18- What is your current weight in lbs? *Enter weight in lbs above

19- Please attach a FRONT PHOTO of your current physique

Your photos are confidential. See the example attached BELOW and upload one that looks similar. *Optional, but this will allow me to explain to you a game plan

20- Please attach a SIDE PHOTO of your current physique.

Your photos are confidential. See the example attached BELOW and upload one that looks similar. *Optional, but this will allow me to explain to you a game plan

21- Please attach a BACK PHOTO of your current physique.

Your photos are confidential. See the example attached BELOW and upload one that looks similar. *Optional, but this will allow me to explain to you a game plan

22- How would you prefer to be contacted? *

Phone call

Text

Whatever is the best for you!

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