NEW CLIENT ASSESSMENT FORM 

This form lets me find out a little more about your body type, lifestyle, and mindset. It helps me understand you, so I can personalize a plan based off YOUR needs! Everyone is different, what works for someone else may not work for you!

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Please CHECK any of the following health conditions that you may currently have or have had in the past:

HEART PROBLEMS

DIZZY SPELLS

arthritis

high cholesterol

BONE/JOINT ISSUES

CURRENTLY PREGNANT

DIabetes

stroke

Other:

Spine/disc issues

Surgery in last 6 months

Asthma

high blood pressure

Family history:

How many days a week do you exercise?

Favorite place you eat for convenience? How often do you eat out weekly? 

Do you smoke or drink? If so, how often?

When were you last in your best physical shape?

What type of improvements are you looking to make throughout your body? Please be specific.

What upcoming events do you have that will motivate you?

On a scale from 1-5, what's your knowledge towards fitness & nutrition? (5 being the most knowledge)

On a scale from 1-5, how familiar are you with macros? (5 being the most knowledge)

On a scale from 1-10, how serious are you about obtaining these goals? (10 being the most serious)

I have read the and agree to the Release of Liability and Agreement Declarations