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New Page
Home
MEMBERSHIP SERVICES
MEMBER LOGIN
Transformations And Testimonials
About Us
Contact Us
Class Schedule
Getting Started
Please fill out the form below as honestly as possible
Name
*
First Name
Last Name
Email
*
Phone
*
What are your specific goals for the next 8-12 weeks?
*
What do you feel is your largest obstacle or problem stopping you from reaching your fitness goals?
*
In 3 sentences or less.
What kind of assistance would you like to help to achieve your goal and overcome your problem?
*
In 3 sentences or less.
How many hours per night do you sleep?
Do you smoke?
Yes
No
Do you drink alcohol? If so how much and how often?
Would you say you have a good grasp of nutrition for your specific goal?
Do you have any allergies?
Do you suffer from any diseases? Please list any.
Which medications do you take?
Do you have any injuries or chronic pains? Please list them
Which supplements do you take?
How many times per week do you typically eat out?
Do you prepare your food beforehand?
How much water do you drink daily?
What drinks besides water do you drink?
Go through a typical day of eating for you. Do one weekday and one weekend day. Please try and include time of day as well as what you might be doing around that time (ex. at work). Please be as open, honest and specific as possible. Also include any snacking.
What has worked for you in the past?
In 3 sentences or less?
Do you think you need a meal plan?
How do you want to record and report your nutrition? Please choose all that apply toi you.
My Fitness Pal
Fitbit
Written report of daily nutrition (sent in app)
Photos of daily meals (sent in app)
Thank you!
