Personal Information
First Name
Last Name
Email
*
Phone
*
Your Goals
What is your primary goal?
*
Lose fat
Build muscle
Improve overall fitness
Current Weight (lbs.)
Weight Goal (lbs.)
You got this!
Gender
Female
Male
Your Age
Height
Do you need a personal trainer?
Yes
No
Almost done
Where do you prefer to workout?
At home
At the gym
Outdoors
Combination of the above
What is the current diet that you follow?
Balanced diet
High protein diet
Vegetarian / Vegan
No current diet
"Seafood" diet. If I "see food", I eat it.
Last page, I promise!
Level of physical activity
Sedentary (little to no activity)
Lightly Active (light exercise 1-3 days per week)
Moderately Active (moderate exercise 3-5 days per week)
Very Active (hard exercise 6-7 days per week)
Please list any medical conditions or injuries (past or present) you think I should know about.
What kind of support are you looking for in your fitness journey?
