Your Name
Your email address

What is your age?

What is your height?

What is your current weight (lb)?

What is your overall IDEAL weight (lb)?

How much weight (lb) would you like to lose or gain by the end of your program?

What is your WHY, the reason you want to lose weight/body fat, gain muscle/tone up, change your lifestyle to get healthy?

Are there any foods you don’t like?

Are there any foods you are allergic to?

Are you currently taking any medications and/or supplements? If so, which ones?

Do you have any injuries we should know about?

How many hours of sleep a night do you get on average?

How many ounces of water do you drink a day?

What workouts and exercises have you done in the past that you enjoyed?

What is your current level of fitness? 

Do you have a gym membership? If so, to what gym?

How many days a week can you get to the gym? Do you have a preference on which days during the week we schedule your REST/OFF days from working out?

Do you have exercise equipment at home? If so, please list the equipment.

Where do you prefer to complete your fitness program?

On a scale of 1 to 5 with 1 = not confident and 5 = very confident, what is your current level of confidence about your body?

What areas of your body do you want to target? (glutes, legs, triceps, waist, chest, etc.)

Do you have a preference on which day during the week you would like to log your weekly accountability photos and body stats on Trainerize?

Do you have any travel plans during the time of your program? If so, where will you be going and when?

Is there anything else you want us to know or be aware of?