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Stephen Cabral
Stephen Cabral
Online Fit Life Coaching
Since I are only able to work with a limited number of clients, I am very selective about my
application process. I take great pride in developing my programs and providing superior customer
service and as a result this can be quite time consuming. Therefore, to be fair to all of my current
coaching clients not everyone who applies for my private coaching program will be selected.
One-On-One Personal Training Application
!
!
In order for me to have a better understanding of what type of program you are
looking for, please complete the following 5-minute 50 Point Health
Questionnaire below. After you submit the form Stephen Cabral will review
your application and will contact you about his private coaching program.
Health Questionnaire



Name:

Phone # (day/evening):

Email Address:

Birthdate:

Male or Female:

Height

Weight:

Optimal Time to Exercise:

Occupation:

How did you hear about us:
Which program are you most interested in: (Hold down the control key to select
multiple categories.)
Please check the box to the left of the condition if you have any of the following:  
Heart Disease

Pulmonary Disease

Metabolic Disease

Family History of Heart Disease

High Blood Pressure

High Cholesterol

Smoking

Sedentary Lifestyle

Chest Pain

Dizziness

Shortness of Breath

Irregular/Accelerated Heart Rate

Osteoporosis
Are you over 69 and not used to being active?

Is your physician prescribing medication for a blood pressure or heart condition?

Has a physician ever told you that you have a bone or joint problem that will
worsen with exercise?
Do you know of any reason why you should not participate in physical activity?
How many days a week are you currently working out? (0-7x)
How long are your typical workouts? (ie. 30 minutes weights/ 30 minutes cardio, etc)
How many days a week would you realistically like to see yourself working out?
Describe Your Ideal Personal Trainer (personality, special interests, etc.)
What Are Your Fitness Goals (weight loss, definition, energy gain, etc.)
What are your interests (running, biking, swimming, etc)
Why should you be chosen as a candidate to work 1-on-1 with Stephen Cabral?
Congratulations! If you’ve made it this far you are well on your way to achieving
any goals that you have set for yourself. Your determination and the correct
exercise program will keep you motivated and attaining your goals!
Arthritis/ Joint Pain

Back Pain/Spine Disorder

Musculoskeletal Pain/ Injury

Hernia

Surgery

Other

Hypoglycemia

G.I. Disorder

High Triglycerides

Cancer

Pre/Postnatal

Anemia

Food Allergies
You've taken the 1st step toward achieving all of your health & fitness goals!
Please fill in as much information as possible to allow Stephen to have the best
possible picture of how he can help you achieve your goals.
Yes Steve! I want to be one of the new clients you accept this month for your one-one
coaching program. I understand that the application process does not ensure that I will be
selected, but I am serious about transforming my body and my health!

Please fill out Stephen Cabral's new client application below:
Private One-on-One Coaching at my Boston Body Transformation Studio:

If You're a Boston Resident or Would Be Interested in Coming to
Boston to Work with Me in Person and Want Your Own Customized
Nutrition, Exercise, and Lifestyle Transformation Package this is the
Ultimate Way to Work in Person with Me.

"I am  only able to take on 1 new client per month and it's by application only. If you're
truly serious about changing your body and your health I can personally guarantee
your success with my revolutionary training expertise and over 11,397 sessions of
proven results!

$200-250 per session, or $89 per session with one of my fitness professionals

Please fill out the application below to personally work with me or go to Stephen Cabral
Studio to fill out this form to get started working with one of my hand-picked team
members! You can also join my semi-private Cabral Conditioning group here.
steve@stephencabral.com                                                                                                                                              Stephen Cabral Body Transformations, LLC
Stephen Cabral, CSCS, CPT, NS                                                                                                                                                           Lifestyle Transformation Coach
                                                                     steve@StephenCabral.com
VIP Private Success Coaching

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