Please take a few minutes to tell me a little about yourself and your fitness goals. Take your time with this, what you put here is very important.

1. Your First & Last Name (required)

2. Your Email (required)

3. What are your general fitness goals? (check all that apply)

4. What specifically do you hope to achieve?

Make sure it's something measurable such as a decrease in body fat, build muscle or fit back into your skinny jeans.

5. Why is this important to you?

Seriously, why are you investing your time and money into this? I want specifics.

6. Rate your overall activity level.

7. Rate your ability to perform cardio exercises.

8. What equipment do you have access to?

9. On which days are you available to work out?

10. How frequently can you workout?

11. How much time can you dedicate to each workout?

12. When can you start?

13. Do you smoke tobacco products?

14. Any other comments about what you would like to see in your program?

15. Do you have any existing injuries or conditions that I should be aware of before designing your program?

Physical Activity Readiness Questionnaire (required)

If you answer “Yes” to one or more of the following questions, consult your physician before
engaging in physical activity. Tell your physician which questions you answered “Yes” to. After a
medical evaluation, seek advice from your physician on what type of activity is suitable for your
current condition.

1. Has your doctor ever said that you have a heart condition and that you should
only perform physical activity recommended by a doctor?

2. Do you feel pain in your chest when you perform physical activity?

3. In the past month, have you had chest pain when you were not performing any
physical activity?

4. Do you lose your balance because of dizziness or do you ever lose

5. Do you have a bone or joint problem that could be made worse by a change in
your physical activity?

6. Is your doctor currently prescribing any medication for your blood pressure or
for a heart condition?

7. Do you know of any other reason why you should not engage in physical

I assume all risks and responsibilities as laid out in the TERMS & CONDITIONS