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Client Basic Information Form
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* Indicates required question
Email
*
Your email
Name
*
Your answer
Phone Number
*
Your answer
Date Of Birth
*
MM
/
DD
/
YYYY
Gender
*
Female
Male
Other
Goal
*
Weight loss
Weight gain
Build Strength
Body Transformation
General Fitness
Other:
Required
Height
In centimeters
Your answer
Weight
In Kilograms
Your answer
Past exercise experience
*
Have you engaged in regular exercise before and then stopped?
Yes
No
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