Questionnaire Form

me? avoid much

Name *

First

Last

Email *

Checkboxes

Age *

Height *

Weight *

What are your fitness goals? *

If doing a competition prep please include date, name and location of the show.

What time do you wake? What time do you go to bed? When do you weight train? * *

What type of cardio do you mostly do? How long and how often per week? * *

Provide a sample of food intake for an average day. Include when you wake up and when is your first meal of the day? * *

Where do you train? If at home, what equipment do you have?

(You can skip this if you didn’t purchase workout plans)

List any food allergies and current supplements, including vitamins *

List any foods that you avoid such as meat, dairy, gluten etc. * *

List daily beverage intake, including alcohol, and how much of all beverages is consumed. *

How did you hear about me? * *