Interested in Customized Fitness Program
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First Name *
Last Name
Email *
Phone Number
Tell me about yourself! What's your favorite meal? Ooh & What health goals would you like help accomplishing? *
Why are these goals important to you now? How will it impact your life if you don't achieve them? How will it impact your life if you do achieve them? *
What will you like to have achieved 3 months from now? Be specific, i.e., walk up a flight of stairs without getting winded; build up endurance for hiking; bicycle without back pain. Etc. *
Do you have any injuries which will need consideration when building your program? *
Have you worked with a personal trainer/coach before? How was your experience? What were some of your favorite exercises and methods of training? *
What has kept you from adhering to a work-out routine in the past? *
On a scale from 1-10, how committed are you to achieving your health & fitness goals? *
Tell me briefly about your eating, sleep habits, and stress levels; i.e., Do you have a consistent sleep/wake cycle? Do you sit down for a meal, or eat in a rush? How often do you consume processed foods and drinks? Do you practice any stress coping strategies?
Do you own or have access to exercise equipment? If so, what kind? *
Questions or concerns? *
Time Investment: What days and times of the week will you schedule aside for your routine? *
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