Confirmation Custom Training Plan $24.95/wk VIP

Name *

First

Last

Email *

Phone *

Date of Birth *

Age *

Height (cm) *

Current Weight (kg) *

Experience level *

Just Starting Now
Moderate - have follow a program before
Advanced

How often do you train? *

Just Starting Now
2-4 times a week
Everyday

What are your short term training goals? *

What are your long term training goals? *

Please tell me about your past training experience? *

Injuries that may affect training plans? *

How many days per week CAN your do weight training and how long for? *

Do you feel faint or dizzy when exercising? *

Are you on any prescribed medications? Please list them below *

Do you currently undergo any type of fitness training? If so how often? (Choose one) *

I currently don’t train
Yes I train 1-2x per week
Yes I train 3-5x per week
Yes I train 6+ x per week

What type of training are you currently doing and how often/long ? (Be specific EG- Running 2x 30 mins, Yoga 1x , Weights 3x) *

What is your current daily activity levels? Choose One: *

Sedentary (Office job) Less than 5000 steps per day
Moderately Active (Teacher, retails etc 5000-8000 Steps per day )
Active (Hospitality, manual labour etc 8000-10000 steps per day.
Very Active 12000 + Steps per day

Do you want a home training plan or gym training plan? *

Home training plan
Gym training plan

If you are wanting a home training plan please list equipment in detail below. *

Do you have specific areas you would like to work more on? *

Nutrition

Have you followed a nutrition plan before? If so please list your dieting history, nutritionist and if this was successful for you? *

File Upload

Click or drag files to this area to upload. You can upload up to 5 files.

Lastly if you would like to send pics front side and back along with this info it may help me more with how I will prescribe the exercise. Please see PDF Attachments in introduction email on how to take your progress pictures.