Work 1-on-1 with
The Coach That Cooks
Fill out the form below to apply for your spot on Ben's roster.
Name
*
First
Last
Email
*
Are You on Instagram?
*
Yes
No
Well, we should be friends. Like seriously, come
say hi
.
What About Facebook?
*
Yes
No
Well, we should be friends. Like seriously, go
add me
.
Occupation:
*
Tell me a bit about what you do—be it work, school, or parenting. I want to hear about what you do.
Height
*
In feet and inches, please. (Sorry, I'm terrible with the metric system.)
Weight
*
In pounds.
What's Your Primary Fitness Goal?
*
Lose Weight
Maintain Weight
Gain Weight
Other
Tell Me a Bit More About Those Goals...
*
Tell me more about your goals and how nutrition will help you achieve them.
Describe Your Current Fitness Plan...
*
Get into detail about what you're doing. How many days per week you go to the gym? Are you following any sort of nutrition plan? Do you count carbs? Macros? Steps? ...stuff like that. Give me an idea of where you're at.
How's That Working for You?
*
Are things are going well but you just want to take things to the next level? Awesome. Or are you frustrated out of your mind because nothing you try seems to be working? That's okay too. I'm here to help. If you want, vent some of those frustrations. For one, it'll feel great. But it'll also help me know how I can best help you succeed. It's a win-win.
What Are Some of Your Favorite Foods?
*
As a food lover, I know it's hard to pick favorites. I'm terrible at it, but I wanna take your preferences into account. List anything and everything that comes to mind.
Do You Have Any Special Circumstances, Specific Dietary Needs, or Limitations I Should Take Into Account?
*
Yes
No
Please Explain...
*
This would be a great spot to tell me if you don't eat meat or happen to be a nursing mother. Stuff like that.
What Do You Want to Accomplish By Working Together?
Get specific about the success you want to see in the short term (~12 weeks) as well as the long term (~12 months). Paint a crystal clear picture for me of what that success looks like to you.
How'd You Hear About This Coaching Program?
*
The more specific, the better.
Anything Else You'd Like to Mention?
Phone
This field is for validation purposes and should be left unchanged.