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START YOU DISPLINE JOURNEY
Email
Full Name
Phone
Nickname
Best days and times for weekly check-ins
Any current injuries or past?
Age
Height, Weight & BMI?
Are you interested in a nutrition plan?
Yes
No
Job Title
What goal do you hope to reach through training? (Weight loss, weight gain etc.)
What do you struggle with the most in your fitness journey?
What are your expectations of your coach? (Communication, availability etc.)
Do you have food allergies?
How many hours of sleep do you normally get?
What is your goal weight?
Do you have a chronic disease?
Do you family history of a chronic disease?
Are you currently on birth control?
Yes
No
Describe your monthly cycle. If applicable.
What is your current energy level? 10 being outstanding and 1 being very low energy.
What is your current hunger levels? 10 never hungry and 1 being always hungry.
Do you follow a specific diet? (Vegetarian, vegan, low carb etc)
Do you take any supplements? (List below)
How often do you drink alcohol?
Have you suffered from disorderd eating patterns?
Yes
No
How much water do you drink daily?
Do you have a current gym membership?
Yes
No
Will you be training at home? If so list any equipment you have at home.
Yes
No
Maybe
How many days a week do you do cardio?
How many days are you able to workout per week?
Do you have any prior injuries? If so please list.
Do you have any existing health conditions? If so please list.
How motivated are you towards reaching your golas? 5 being very motivated.
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Do you have any wxisting health conditions? If so list them below.
Submit
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