Fitness & Nutrition

QUESTIONNAIRE

Please take the time and answer following questions in as much depth as you are comfortable with! This will allow me to get a better understanding of who you are and your lifestyle so that we can build the perfect plan for you!

Name

First Name

Last Name

Gender

Male

Female

Age

Height

Weight

Fitness Goal - WHY?

Take your time and explain the real why you want to achieve this!

Importance of Goal

1 being not important 10 being very important

Nutrition Goal - WHY?

Take your time and explain the real why you want to achieve this!

Importance of Goal

1 being not important 10 being very important

Medications / Medical Conditions

Injuries

Other information

Contact information