*1.First & Last Name(Required.)

2.What is your experience level in the gym

Beginner

Intermediate

Advanced

3.What is your height?

4.What is your weight?

5.What does your average week day look like?

6.Where will you be working out at?

Gym

Home

7.How is your current relationship with food?

I have never “dieted” or “tracked”, I eat pretty unhealthy

I know a good bit on how to eat healthy; however I feel like I still need help

I know that I do not eat enough

I know that I eat too much

Other (please specify)

8.Any injuries / mobility issues OR dietary restrictions / allergies I should know about?

9.In your own words, what is your goal - short term (3 months) & long term (1 year) with this journey? Please list any additional comments that will help me better understand your specific situation, goals, or needs.