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Please provide your personal information here for us to send you details on how our program will work for you.
When done, please let us know you have sent in the application via DM to our IG account @victoriaandnatalia.fit or WhatsApp (Victoria Dubinina: wa.me/14697199711)
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Name
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Email
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Occupation
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Weight/Height/Age
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Phone number
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What is your health and fitness goal?
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Instagram handle (e.g.: @winwithv)
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Experience at the gym (years of training; with/without PT; functional/crossfit/stretching/weightlifting etc.)
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Experience in other physical activities (dancing, sports, etc.)
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Do you have gastritis?
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Yes.
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Do you have hernia?
No.
Yes.
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If you do, specify which type.
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Do you have spinal disk herniation?
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Yes.
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If you do, specify where.
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Do you have varicose veins?
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Yes.
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If you do, specify where and whether you have been operated.
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Do you have fallen arches (flat feet)?
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Yes.
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Do you have asthma?
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Yes.
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If you do, specify severity.
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Blood Pressure:
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Have you had any injuries during the last 2 years? Specify.
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Please add anything you feel we should know about your health.
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