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HEALTH AND FITNESS QUESTIONNAIRE
This intake form allows us to gather the critical health and personal information needed to plan for your upcoming meal and workout schedules. You are required to complete this form in order for your health project to start.
Personal information
First Name
*
Last Name
*
Phone Number
*
Date of Birth
*
Email Address
*
Home Address
*
City | State | Zip
*
Gender
*
Age, height
*
Current weight
*
Goal weight
*
What kind of coaching are you interested in?
*
What kind of coaching are you interested in?
A
Lifestyle/health
B
Competition Prep
C
Posing
D
Stretching (pretzel experience)
For clients looking to compete, please list any show dates you have in mind)
*
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