101 Coaching Application

If you are ready to see massive changes in your life (and body), I would love to work with you. I only take on so many clients at one time so I can fully dedicate myself to each and every one. 

Please complete the following questionnaire to apply. 

Click the button below to complete application.


Question 1 of 28

What is your Name? 

Question 2 of 28

What is your e-mail address? 

Question 3 of 28

What is your best contact number and would you accept text messages from Gina? 

Question 4 of 28

How Old Are You? 

Question 5 of 28

How tall are you and current weight? 

Question 6 of 28

Do you have children? 





Question 7 of 28

How would you rate the activity level of your profession or your activity throughout the day- on an average day? 

Question 8 of 28

What is your WHY for completing this application? What motivates you to finally COMMIT to your goals? 

Question 9 of 28

What are your fitness goals? 

Question 10 of 28

Have you ever followed a specific diet or workout program and if so which one (s).

Question 11 of 28

Which do you prefer... 


Home Workouts


I'm a Gym girl

Question 12 of 28

What is your current workout & cardio routine- if any? 

Question 13 of 28

Have you ever had any injuries? If so, please explain... 

Question 14 of 28

Are you currently on any medications? If so, please list them. 

Question 15 of 28

What is your current dietary program (if any)? 

Question 16 of 28

Do you prefer variety in your diet or keeping it simple? 


Variety is the spice of life.


Simple is my game.

Question 17 of 28

Do you like to cook and prepare your meals? 

Question 18 of 28

Please share a sample days diet... 

Question 19 of 28

What are your favorite foods? 

Question 20 of 28

Any foods you dislike or are allergic to? 

Question 21 of 28

What have been your biggest challenges/struggles when it comes to following a fitness program?

Question 22 of 28

Do you meditate or spend any time in stillness? 






Want to but don't know how or have tried and am "not good at it."

Question 23 of 28

If you had to narrow it down to ONE thing that is your biggest blocker, what would it be? 

Question 24 of 28

Why do you feel that NOW you are ready? 

Question 25 of 28

Are you someone who gives up easily or is in this to WIN THIS? 

Question 26 of 28

How did you hear about Gina and why do you think she will be able to help you step up your game? 

Question 27 of 28

Gina is BIG on connection and loves putting a face to her applicants. Please upload a photo of your choice. Solo, family or whatever you would like to share. :) 


Question 28 of 28

You have limitless potential and have EVERYTHING you need to be a success within YOU.

Do you believe this? 


Heck Yes!


Not yet but I want to...


I want to say HECK Yes but no :(

Confirm and Submit