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BodyRock by BK Initial Assessment Form : Intro Month
By learning more about your lifestyle and your habits, I can take better care of you and make sure my coaching is a good fit for your goals and individual needs!
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* Indicates required question
Email
*
Your email
Name (First & Last)
*
Your answer
Birthday
*
MM
/
DD
/
YYYY
Gender
*
Your answer
Height
*
Your answer
Weight
*
Your answer
Phone #
*
Your answer
How would you prefer for me to contact you?
*
Email
Phone
Zoom
Text
Other
Required
Emergency Contact/Phone #
*
Your answer
In general, what are your goals?
*
Lose weight/fat
Gain weight
Maintain weight
Add muscle
Improve overall health
Improve physical fitness
Look better
Feel better
Have more energy & vitality
Healthy aging
Get control of eating habits
Get stronger
Physique Competition/modeling
Improve athletic performance
Get off/decrease medications
Other:
Required
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