Online Training Application
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Email *
Name *
Phone Number *
Age/birthdate *
Height *
Current weight
best guess if unknown
Body fat % if known
how was it measured?
How do you identify? *
If you answered other in the previous question, please describe.
What are your pronouns?
What are your 3 main goals? Please be as specific as possible. *
Why do you want to achieve these goals? Again, please be as specific as possible. *
What do you think are your challenges in achieving these goals? *
Have you tried to reach these goals before? What happened? *
What is your plan for when you reach your goals? *
What is your motivation level right now? *
How confident are you in yourself? *
Not confident at all
Very confident
Which statement(s) best describes you? *
Space for any additional comments about the previous question.
Do you have any concerns about having a fitness program built for you, or anything that you really DON'T want to do? *
What is your current activity level? *
Do you have any medical/health issues? *
What is your previous exercise experience? Type, frequency, time frame. Did you enjoy it? *
Are you currently exercising? If so, what and how frequently. *
Do you have any exercise limitations? If yes, please describe. *
Do you have any current or recurring joint, muscle, tendon or ligament pain? Where? *
Do you have any current or past injuries? If yes, please describe. *
Do you experience any pain or discomfort during exercise? *
Have you lost or gained a large amount of weight before? Please describe. *
Have you followed a nutrition plan or diet before? *
If yes, please describe: what kind, when, how long, how successful was it?
Do you, or have you ever had disordered eating? *
Are you under high amounts of stress? *
Are you pregnant? *
Are you breast/chest feeding? *
Do you have stress incontinence? *
Leaking of urine when coughing, sneezing, jumping, running, etc.
Do you have urge incontinence? *
Leaking of urine when the bladder is full
Do you have anal incontinence? *
Inability to hold in gas and/or stool
Do you have diastasis recti? *
separation of the abdominal muscles
Do you or have you ever had a hernia? *
Do you have pelvic organ prolapse? *
Have you given birth? When? Any complications? *
Do you track the following biomarkers? *
What kind of motivation works best for you? *
Where will you be doing your workouts? *
If other, please describe
If you will not be exercising at a large gym with a wide variety of equipment, what will you have available to you?
Are you willing to purchase weights or other equipment? *
Is there anything else you would like us to know about you?
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