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Welcome!
Thank you for choosing me to help guide you through your health and fitness journey! Please complete the following assessment so I can best assist you through your weight loss journey!
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Email
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(Name)First & Last
Your answer
What is your number one goal when it comes to your physique?*
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Age
Your answer
Height
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Weight
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Activity Level
Sedentary - little to no exercise, desk job, barely hit 2 k steps
Lightly Active - exercise 1-3 days a week and/or achieve about 5k steps per day
Moderately Active - exercise 3-5 days a week and 10k steps a day
Very Active - heavy exercise 5-7 days a week plus over 10k steps a da
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How many steps on average do you get per day?
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What do you do for a living/what does your daily movement look like? (desk job, nurse, etc)
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What is your current goal?
Fat Loss
Body Composition
Muscle Gain
Better Relationship with food
Building Healthy Habits
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Are you nursing?
*
Yes
No
Can you explain what you're hoping to achieve if we work together? As much detail as possible :)
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Do you have any dietary restrictions or preferences?
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Do you have any injury's that I should be a where of?
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Do you have medical clearance to workout?
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Yes
No
Are you new to tracking macros?
Yes
No
Kinda- I have dabbled but still learning
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Have you worked with a macro coach before?
Yes
No
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Do you have a current macro count? If so please put below what your current protein/fats/carbs are in grams.
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What are your current eating habits? How many calories are you consuming on average each day? Please add as much detail here as possible. If you have been tracking macros... do you consistently hit your numbers every day?
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What does your current weekly exercise routine look like? Please be as specific as possible. How many minutes/hours per week do you strength train? How many minutes/hours per week do you spend doing cardio? What does cardio look like to you?
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Who would you consider yourself to be..
A self-starter! Give me a plan I can execute on my own.
I need 1:1 Accountability! Someone to hold my hand & push me every step of the way.
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Clients that enroll with me are required a 3 month commitment, is this something you are open and able to do?
Yes
No
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