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  1. How did you find out about the Dr. Kareem Coaching Program?
  2. Have you ever been diagnosed with any health conditions and/or are you currently taking any medications that we should be aware of? If so, please list and explain.
  3. If you answered no above, simply type N/A in the box below. If you answered yes, do you have clearance from your physician to participate in a regular exercise program? (Please forward your physician’s clearance to us right away at [email protected], as we will need this on record)
  4. How would you rate your current level of fitness? Poor, Fair, Average, Good, or Excellent?
  5. Why are you applying? Please briefly describe your goals for the next 16 weeks (short-term), in terms of what you’d like to see happen with your body and health?
  6. Please briefly describe your long-term goals with your body and health (longer than 16 weeks)
  7. Why are these goals important to you? In other words, what makes it different this time, that makes you motivated to actually hit your goals, as compared to before?
  8. Why do you want to be a part of the Dr. Kareem Coaching Program at this time?
  9. How important do you feel personal mentoring is to achieving your health and fitness goals? Not important, Somewhat important, Very important?
  10. Are you 100% willing to commit your FULL effort to this coaching program?
  11. Why do you believe that you will be successful at implementing your program consistently?
  12. In your mind, what are the consequences of not taking action?
  13. How will you feel if you don’t hit your goals? What will your life be like?
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Please click the button above to submit your application. Response time is generally 3-5 business days, as we receive a lot of applications while our coaching program is open and available.