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Moxie Performance

About
Coach
Why MPG
Remote Coaching
Merch
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Welcome to Your
personalized programming

We're so pumped that you're interested!

Moxie Performance provides personalized, day-by-day training plans designed to fit your unique needs and help you achieve your fitness goals with expert guidance and support. With tailored workouts, nutrition education, and direct access to your coach, Moxie Performance is committed to ensuring your progress every step of the way!

Fill out the form below to help us get to know you better and make sure we're a great fit. We're here to help you crush your fitness goals.

Let's get started!

Limited Spaces Available!

What are you interested in?*

Remote Coaching

Nutrition Coaching

Both!

Personal Info

Full Name*

Birthday*

Month

Day

Year

Gender

Email*

Phone*

Address*

Emergency Contact*

Emergency Contact Phone*

Health and Wellness

Health conditions I should know about?*

Are you taking any medications or supplements? if yes, what are they?*

Do you have any allergies? if yes, environmental, dietary, or other?*

Do you have any past injuries (surgeries) I should know about?*

Do you have any exercise restrictions?*

Nutrition - Overview

Have you experienced any digestive issues (e.g. bloating, acid reflux, etc)? if yes, please describe.*

Does your family have a history of diet-related conditions (e.g. diabetes, heart disease, etc)? if yes, please specify.*

Nutrition - Dietary Habits

How would you describe your current eating habits?*

Well Balanced

High in processed foods

Low in fruits and veggies

High in protein

Other

How many meals do you typically have per day?*

1-2

3

4+

It varies

Do you snack between meals? if yes, what are your usual snacks?*

How often do you dine out or order takeout?*

Rarely

1-2 times a week

3-4 times a week

5+ times a week

Other

Are you currently following any specific diet or eating plans? if yes, what is it?*

How often do you drink alcohol?*

Never

Occasionally

Regularly

Do you drink coffee or caffeinated beverages? if yes, what and how much?*

Nutrition - Goals & Preferences

What are your main nutrition goals?*

Weight Loss

Building Muscle

Increasing Energy

Improving Digestion

General Health

Other

What challenges do you face with your current diet?*

Not enough time to cook

Cravings

Emotional eating

Confusion about what to eat

Other

How motivated are you to make changes to your diet?*

Super motivated!

I'm ready, but it's going to take some work.

I'm interested, but I'm not sure I'm ready yet.

Do you have any strong food preferences or dislikes? if yes, please list them. *

How comfortable are you in the kitchen?*

Pro Chef

Decent Cook

I can follow a recipe

I'm more a takeout person

Are you open to trying new foods? if no, what's holding you back?*

Fitness Background

How often do you workout?*

Couch Potato

Sometimes

Regular

Gym Rat

Favorite ways to move? (e.g. running, dancing, weightlifting)*

Have you ever had a personal trainer? if yes, how did it go?*

Goals and Preferences

What are your fitness goals?*

Shed some pounds

Pack on Muscle

Boost Endurance

Flexibility Master

General Wellness

Other

What keeps you moving?*

Health First

Look Good Naked

Reduce Stress

Social Fun

Other

How many days do you want to train?*

What time do you prefer working out?*

Morning

Afternoon

Night Owl

Do you have any gear at home? (if yes, list them out)*

Are you following a diet or nutrition plan?*

Extras

How did you fine MPG?*

Social Media

Word of Mouth/Referral

Surfing the Web

Other

Is there anything else I should know?*

Contact us

First name*

Last name

Email*

Write a message

Remote Training

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Photos - Alex Scott Felice

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