EmpowerU Men Application Form
EmpowerU: MEN focuses on supporting three pillars to enhance testosterone production; strength training to aid building lean body mass while decreasing fat, balanced nutrition and guidance with lifestyle coaching.
Instagram Handle (or FB Profile Name)
Date of Birth
List any current and/or past injuries, surgeries and/or any other medical limitations. If none, write “none”.
Have you ever had your testosterone tested?
What is your #1 struggle to improve your health, fitness, nutrition, strength, mindset and/or overall well-being?
What does success look like to you? What would you like to accomplish in the next 3 months?
Which best describes you?
New to fitness & want to improve overall health
Not a FitPro or Fitness Enthusiast, but been doing this fitness & nutrition thing for a long time & struggle with certain things.
On a scale of 1-10 how committed are you to become EMPOWERED to take control and to find the best man you can be?
I am tired and fatigued and OK with this
I want my best life and want to THRIVE!
A copy of your responses will be emailed to the address you provided.
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