Client Intake Questionnaire
Fat Adapted Academy Intake Form
Email address *
Welcome to...
First Name *
Last Name *
Where do you live/are you from?
What is your height? *
What is your weight? *
What is your estimated bodyfat % according to the navy bodyfat calculator? http://fitness.bizcalcs.com/Calculator.asp?Calc=Body-Fat-Navy *
What is your exercise and training history and ability (any limitations)? *
If you have done resistance training, what is your 1 rep max on the following lifts: ● Bench● Squat● Deadlift● Overhead Press. *
How many days per week are you able to train? *
What equipment do you have access to? *
What is your occupation and activity level associated with this work? *
What is your current average stress level on a daily basis on a scale of 1-10, 10 being extremely high? *
What does your current diet/nutrition look like? (Include as much detail as possible) *
What is your medical history? *
What are your primary and secondary fitness goals? *
How many hours of sleep do you get per night? Do you wake up rested? *
What are you looking to gain from your coach throughout the coaching period(nutrition coaching, resistance training program, both)? *
Are you able to do a progress check-in weekly with nutrition intake data and biweekly with progress photos/measurements? *
How is your sleep rhythm and quality? *
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