First Name
Last Name
Phone
*
Email
*
What makes you a GREAT applicant for my program?
How much weight do you have to lose? Or would you like to build lean muscle?
Do you have access to a gym outside of mine? If so, where?
Do you have experience in the gym? If so, how much? Specify the type of training you are used to.
What equipment is available?
Please list any medical concerns or injuries/health related illnesses I should be aware of
Have you had recent blood work? If so, please email to
[email protected]
Please describe your current diet in detail and what you had the last two days for meals
If chosen, would you agree to follow my orders and requests for nutrition and functional medicine related work if hormones or body changes would be needed?
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