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Women’s 40+ Pathway to Strength & Longevity

Full name

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Date of birth

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Phone number

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Email address

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Current training level

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Current training level

I don’t currently train

I walk / perform light activity (yoga/pilates)

I train 2 - 3 times per week (strength/cardio)

l train consistently 4 + times per week

How confident are you with strength training?

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How confident are you with strength training?

Not confident at all

Confident with basics

Very confident with lifting weights

Tell me about your current weekly training schedule

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What is your primary goal right now?

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What is your primary goal right now?

Lose Body Fat

Build Muscle

Improve Bone Density

Improve Energy and Health

All of the above 👆

Have you ever had a DEXA or bone density scan?

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Have you ever had a DEXA or bone density scan?

Yes

No

I don’t know what that is

What is your biggest frustration right now?

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What is your biggest frustration right now?

I can’t lose weight

I feel weak / losing muscle and strength

I don’t know what to do in the gym

I’m inconsistent and need structure

Hormones / peri-menopause or menopause symptoms

Do you have any current or previous injuries? Please provide details.

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Tell me a little more about yourself and anything else you might like to add that will help me understand your future goals.

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