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Goal Intake Form
Contact me:
(780) 915-7296 or Kingkycer@gmail.com
Gym Location:
4720 76 Ave NW, Edmonton, AB T6B 0A5
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Email
*
Your email
Name
*
Your answer
Gender
*
Male
Female
Other:
Age (Must be over 18)
*
Your answer
Phone Number
*
Your answer
Email
*
Your answer
Do you have any Injuries or problem area's when it comes to training? If I can fix any of these issues what would that mean to you?
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Your answer
What are your Main Goals?
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Weight Loss
Muscle Gain
Athletic Performance
Rehabilitation/Recovery/Medical
Lifestyle boost
Required
What is your SPECIFIC Goal? Examples: run 1/2 marathon, lose 10 pounds, be able to do 10 pull ups, bring your blood pressure to a safe level...
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Your answer
What is the timeframe you have for your goal?
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1-3 Months
3-6 Months
6-12 Months
1-2 Years
2+ years
Required
Which aspects of training are you needing help with more?
Knowledge (Having a desire to learn to eventually become independent)
Accountability (Making sure that you are not skipping your workouts or meals)
Competition or Sport ( You want to excel in your sport or competitions)
Programming (Prioritization of Diet or Exercise plan)
How active are you at work?
Sedentary/Dormant (0-2 hours of exercise)
Active (Over 2 hours but less than 6)
Very active (Physical activity over at least 6 hours a day)
Clear selection
Which Plan/Offer are you most interested in of mine?
1 on 1 In-Person Sessions
Meal Plan Online
Workout Plan Online
Both Workout + Meal Plan
What is your commitment level
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Low Commitment
1
2
3
4
5
6
7
8
9
10
High Commitment
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