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Basic Introductory Details & Questions
THIS FORM IS FOR PAID CLIENTS, ONLY!
Please fill out this form to help me gain a better understanding of where you are, where'd you'd like to be, and how to get you there.
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Email
*
Your email
Name
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Gender
*
Female
Male
Weight
*
Your answer
Height
*
Your answer
What is your fitness goal?
*
Lose fat or inches
Gain weight/ bulk up
Maintain
On average, how many days a week do you workout?
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1
2
3
4
5
6
7
Give me an example of what your workout regimen consists of for an entire week.
*
Your answer
Categorize the activity level required for your job.
*
Sedentary- I have a desk job (I may still walk and stand during the day).
Active- I'm on my feet the majority of the day and perform manual labor.
Athletic- My job requires hard physical work and heart rate elevation for extended periods of time.
Accountability Advising (NOT required for nutrition coaching): Tell me about your goals and what you would like to be held accountable for.
Your answer
A copy of your responses will be emailed to the address you provided.
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