If you're ready to take the first step, please submit the following form and Jessica will be in contact with you!

(Please note that business is currently quite busy, therefore Jessica is not always immediately available to answer emails. - Please expect a 1-5 day response wait. Thank you for your patience during this time.)

Questions? Visit the Q&A page or e-mail JessicaRoscoeFIT@gmail.com

Name *
Name
Phone *
Phone
Does this number send/receive text messages? *
Date of Birth *
Date of Birth
Which services are you interested in? *
Please select all that apply.
Please list referrals.
EX: to gain confidence, cure an ailment, strength, endurance, gain size, lose weight, compete, etc.
Please include all prescribed medications, vitamins & supps (including protein) - and the amount & time taken.
Please list both healthy & unhealthy foods.
Please list both healthy & unhealthy foods.
Please be specific, including approximate amount & time eaten.
EX: school sports played.
Please include show, date, placings, stage weight, and previous coach. -SKIP question if never competed-
EX: Lifetime, LA Fitness, YMCA, apartment gym, etc.
Please be as specific as possible.