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Question 1 of 22
First and last name?
Question 2 of 22
Birthday
Question 3 of 22
How tall are you?
Question 4 of 22
How much do you weigh?
Question 5 of 22
How old are you?
Question 6 of 22
What is your current occupation?
Question 7 of 22
Provide a detailed description of your goals (fat loss, muscle gain, compete, target areas)
Question 8 of 22
How many years have you weight trained? (if at all)
Question 9 of 22
What is your current training regimen like? Please include split and how you feel it works for you?
Question 10 of 22
What is your current cardio regimen, if any?
Question 11 of 22
Do you have access to a full gym
Yes
No
Question 12 of 22
How many days per week are you currently training?
Question 13 of 22
How many days per week are you willing to train?
Question 14 of 22
Do you know your current daily calorie intake? (even if rough estimate)
Question 15 of 22
In regards to your current food intake, have you been gaining, losing, or relatively maintaining?
Gaining
Losing
Maintaining
Question 16 of 22
Indicate your activity level below- essentially how active you are while away from the gym
Sedentary
Lightly active
Active
Very active
Question 17 of 22
How many untracked, “cheat” or free meals are you currently having on a weekly basis?
Question 18 of 22
List any current supplements or doctor prescribed medications that you are taking?
Question 19 of 22
Any other information that you could provide that you feel would be vitally important for me to know before we work together?
Question 20 of 22
Do you have a regular menstrual cycle? If not, can you explain? If so, are you on birth control?
Question 21 of 22
How good is your sleep currently? (1-no sleep whatsoever, 10- 8+ hours of sleep)
Question 22 of 22
How stressed out are you currently? (1-not stressed, 10- EXTREMELY stressed)