Full Name *

Email *

Phone *

Height *

Current Weight *

Do you have any medical conditions you wish to disclose? (I.E. diabetes, hypothyroid, high cholesterol, etc) *

By checking this box, I consent to receive email messages from Coach Aaron of Plant Powered Method. These messages may include appointment reminders, and free guides among others. Message frequency may vary. HELP for help or STOP to opt-out.

By checking this box, I consent to receive text messages from Coach Aaron of Plant Powered Method. These messages may include appointment reminders, and free guides among others. Message frequency may vary. HELP for help or STOP to opt-out.

Goal Review Section

What is your primary fitness/weight loss goal? *

What does success look like for you 90 days from now?

Have you done any fad diets/what have you tried in the past? *

Where do you usually get stuck when trying to lose weight/build muscle?

How many calories on average are you eating per day?(if not tracking, provide a rough estimate) *

How would you rate your protein intake? *

How would you rate your food quality? *

Do you find yourself consuming large amounts of coffee or energy drinks to get through the day? *

How would you rate your daily energy levels? *

How would you rate your daily stress levels? *

Do you find that you are able to cope with and manage your day to day stress? *

If you answered yes to the previous question, how do you cope with day to day stress (ex. walks alone, meditation, reading, watching TV) *

On average, how many hours of sleep do you get each night? *

How would you rate the quality of your sleep? *

Do you have a sleep routine (I.e. go to bed and wake up at generally the same time each day) *

How active are you? *

What’s one thing you’ve been avoiding or putting off when it comes to your health?

This assessment is not about coaching but are you interested in hearing more about 1 on 1 coaching? *