Please complete the form below Name * First Name Last Name DOB * Age * Email * Height Weight Do you smoke? How much? Do you drink? How often? On a Scale 1 to 10, how motivated are you to reach your goal(s)? What is the reason you are looking for online/in person coaching? What do you want to see change with your body? What do yo currently do for physical activity ? Years of training experience (if any) Current training split (how often do you train per week and how to you break down your different muscle groups including cardio) Food allergies or dislikes Injury(s) Details about injury(s) Past illness or medical condition & details Recent blood work (any abnormalities) History of high blood pressure? List of any medications Are you happy with your current state of health right now? What are your short-term fitness goals? What are your long-term fitness goals? what is your dominant hand? How many meals do you eat per day? Please list your current nutrition habits Breakfast Lunch Dinner Snacks How much water do you drink a day on average? Sleep: how long on average? Stress: 1 none 2 some 3 Alot Thank you!
