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10-Week Challenge - Client Intake Form
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Email
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Your email
Full Name
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Your answer
Phone Number
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Your answer
How did you hear about our us?
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Facebook
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Friend
Other:
Gender - Female
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Date of Birth
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Your answer
City
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Your answer
If you plan on doing our Group Training 10 -Week Challenge workouts, what are the ideal days and times you are looking to attend?
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530am --> Tuesday + Thursday
630am --> Tuesday + Thursday
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WORKOUT HISTORY- What is your current workout history? What type of workout are you doing now? What do you feel might be missing that you'd like to include?
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Your answer
HEALTH / MEDICAL - Are there any health concerns, medications or injuries that we need to know about?
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Your answer
List your emergency contact person, relationship & their cell phone number:
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Your answer
GOALS / CHALLENGES - What are 3 of the most important goal you want to achieve? Why is this so important to you right now? What is the biggest obstacle that you need to overcome to make this happen?
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Your answer
What do you do for a living?
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Your answer
FITNESS - How would you rate your current level of fitness?
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NUTRITION - How would you rate your current eating habits?
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STRESS - How would you rate your current level of stress?
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SLEEP - How would you rate your current quality of sleep?
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