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Cane and Able Fitness Remote Coaching Intake Form
Fill out this form to request coaching and give us all the details we need for your custom program.
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Name
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Your answer
Email Address
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Your answer
Age
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Your answer
Current Height and Weight (in Feet' Inches" and LBS
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Your answer
What is your training history? (include sports previously or currently playing, experience lifting weights, current regime, etc.)
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Your answer
What are your goals with this program? (Be specific!)
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Your answer
What limitations do you have? INCLUDE VISION STATUS.
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Your answer
What equipment do you have available? (include if you attend a gym, equipment there and your familiarity with it, etc. If you need workouts for home, detail what space and equipment you have)
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Your answer
What is your medical history? Include all important health risks or previous injuries.
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Your answer
Medications being taken:
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Your answer
***NOTE*** Permission from a Medical Practitioner to exercise heavily may be required prior to starting training program.
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