Let’s work together.Interested in working together? Fill out some information to make sure there is a fit! Name * First Name Last Name Email * Phone (###) ### #### Age? Current Weight? Desired Weight? Height? What specific fitness goals are you looking to achieve? What challenges have you faced in the past when trying to reach your fitness goals? Are you willing to commit to a personalized fitness program and follow the guidance provided? Are you currently taking any medications or supplements? How would you describe your current energy levels and overall sense of well-being? How Much Sleep Do You Get Per Day? Less than 4 hours 5 hours 6 hours 7 hours 8 hours 9 hours 10 hours more than 11 hours How would you rate your stress levels on a scale of 1 to 10, with 10 being the highest? 1 (Lowest) 1 (Lowest) 2 3 4 5 6 7 8 9 10 (Highest) Do you have any specific time constraints or scheduling limitations that I should consider when designing your fitness plan? How motivated are you to make a positive change in your health and fitness? 1 (Lowest) 2 3 4 5 6 7 8 9 10 (Highest) How do you handle setbacks or challenges when it comes to your health and fitness goals? Are there any other factors or information you believe would be important for me to know to help you succeed in your fitness and nutrition journey? Any medical symptoms that show up within a yearly or more frequent basis? Do you smoke, if yes, what? Do you drink Alcohol? Thank you!