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Initial Nutrition and Fitness Form
Fill out this form to give me a better understanding of your personal needs and path to hit those goals. We'll chat soon!
-Coach Andrew
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Email
*
Your email
Name
Your answer
Age
*
Your answer
Sex
*
Male
Female
Prefer not to say
Weight
*
Your answer
Height
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Your answer
Health Conditions - Select All That Apply
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Anemia
Celiac Disease
High Cholesterol
Hypertension (High Blood Pressure)
Prediabetes
Type 1 Diabetes
Type 2 Diabetes
No Known health conditions
Other:
Required
What did you eat in the last 24 hours? Include it all: breakfast, lunch, dinner, and drinks/snacks.
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Your answer
On a scale of 1-10 how comfortable do you feel with tracking macros?
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2
3
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10
If you're currently training, what are you doing? (i.e. Lifting weights, cardio only, cross-fit, powerlifting, etc.)
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Your answer
What is you typical activity level per week?
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Choose
Very Light (almost no purposeful exercise)
Light (1-3 hours of gentle to moderate exercise)
Moderate (3-4 hours of moderate exercise)
Intense (4-6 hours of moderate to strenuous exercise)
Very Intense (7+ hours of strenuous exercise)
Goal(s) - Select All That Apply
*
Building Muscle
Lose Weight
Eat More Veggies/Antioxidants
Improve Endurance
Increased Energy
Increase Fiber
Diabetes Management
Manage other Medical Condition
Other:
Required
What supplements and/or medications are you currently taking?
Your answer
What are your fitness and/or health goals in the next 90 days?
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Your answer
What has been your biggest obstacle to reach these goals?
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Your answer
On scale of 1-5 how ready are you to make a financial investment in your health & fitness?
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5
What is your availability for a chat in the next 48 hours?
Your answer
Phone Number
*
Your answer
I will reach out to set up a time to chat. You will receive a Zoom link and text reminder for our call. You ready?!
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LET'S DO IT!
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