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* 1. Contact information

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* 2. What program are you interested in?

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* 3. Do you have a bone, joint or any other health problem that causes you pain or limitations that must be addressed when developing an exercise program (i.e. diabetes, osteoporosis, high blood pressure, high cholesterol, arthritis, anorexia, bulimia, anemia, epilepsy, respiratory ailments, back problems, etc.)?

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* 4. What is your fitness goal? BE SPECIFIC (SMART goals)
S= Specific (Provide details, how long, how much etc.)
M= Measurable (How will you measure whether you’ve reached your goals)
A= Attainable (Be realistic, set smaller goals)
R= Rewards-Based (Attach a reward to each goal)
T= Time Frame (Set specific dates for goals)

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* 5. How often are you able to train?

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* 6. How active are you?  
Exercise: 15-30 minutes of elevated heart rate activity.
Intense exercise: 45-120 minutes of elevated heart rate activity.
Very intense exercise: 2+ hours of elevated heart rate activity.

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* 7. Please enter the following (Age, Gender, Height(ft), Weight(lbs))

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* 8. What equipment do you want to use? Is a gym available to you? (Bodyweight, weights, both, etc)

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* 9. Would you be comfortable with making your transformation public? (I.e, allowing me to post you on my social media).

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* 10. Do you understand that I am NOT a certified personal trainer/nutritionist and that my service is solely based on my experience and personal research?

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