Consultation Form Part 2

A deeper understanding

    General inquiry:

    What is your body type?


    Body fat percentage?




    General Health & Medication:

    On a scale of 1 - 10, how would you rate your motivation level?

    On a scale of 1 - 10, how would you rate your overall fitness level?

    On a scale of 1 - 10, how would you rate your overall stress level?

    Nutrition:

    Current Dietary Practices (Write out a sample day of eating below)

    Mindset:

    What obstacles do you see that may prevent you from reaching your health and fitness goals? Please specify (if any)?

    Are you 100% committed to getting results?