Name* First Last Email* Height* Age* Weight* Has your doctor ever advised you to be cautious of physical activity. Do you have a history of injuries? Any surgeries?*What is your occupation? Do you find yourself sitting for most hours of the day?*How many days of the week do you, or would you like to workout?*What exercise equipment do you have access to? Please specifyWhat is your daily activity aside from your time in the gym? (Refer to PDF for more information)*What is your current caloric intake? Please estimate if you do not know.*Please explain your current goals in detail.Strengths? Weaknesses?If you have tracked macros before, what has worked best for you in the past? What has not and why?Favorite thing to do or eat?? (Just a fun question, I want to get to know you :))Program Duration Selection*8 Weeks-$220/month12 Weeks-$210/month16 Weeks-$200/monthConsent* I agree to the policy.I am not a physician or registered dietitian. My role as a Certified Personal Trainer is not to diagnose, treat, cure or prevent any health problem-nor am I able to provide the same advice as a physician. Always consult your physician or qualified health professional on any matters regarding your health. Please advise my services are suggestions and advice based on my knowledge and certification. Total $0.00
