ATHLETE GENERAL INFORMATION
Name *
Name
Phone *
Phone
If applicable
http://
If applicable
Discounts are available
Are you sedentary or active? Do you track steps?
ATHLETE BIOMETRIC INFORMATION
mm/dd/yyyy
Feet / inches or meters
lbs or kg
ATHLETE GOALS
Past 12 week timeframe
Please be specific
NUTRITION, TRAINING & CARDIO
PLEASE PROVIDE AN HONEST OVERVIEW OF YOUR CURRENT NUTRITION, TRAINING & CARDIO PROTOCOLS. THERE IS NO RIGHT OR WRONG ANSWERS JUST HELPFUL INFORMATION TO SEE WHERE YOU ARE AT.
NUTRITION
If so, which one did you track and for how long?
Include ALL meals, snacks and water intake.
TRAINING
Are you doing any splits? ie. Monday - Legs, Tuesday - Back etc...
CARDIOVASCULAR TRAINING
How many days a week do you perform cardio?
Low intensity, medium intensity, high intensity, circuits...
MEDICAL INFORMATION
Examples include: Type II Diabetes, Hypertension, Chronic injuries, Surgeries, etc..
Are you pregnant or nursing? *
GENERAL INFORMATION
Hours / Night
Are you currently working with a trainer? *
Communication, training methods, support, etc.
mm/dd/yyyy