AMPT Lifting
Client Submission Form
What’s your name? First name is fine ☺️
First Name
Last Name
How Old are you? 👨🏻💼
Do you already go to the Gym? 🏋🏻♂️
Yes
No
Do you have any Health Issues/Disablities? If so Please Explain 🩺
Which of these goals fits you best? 🎯
Lose Weight, Gain Muscle (Recomp)
Gain Weight & Muscle (Bulk)
Strictly Fat/Weight Loss (Cut)
Other
If you said “other”, or have any additional goals you would like to add/highlight; please specify 🙋🏻
On a scale of 1-10, how is your general fitness/activity level? (1 being Couch Potato and 10 being Olympic Athlete) 🥔 🏃🏻♂️➡️
Which of the following barriers are holding you back from your potential gains? 🛑
Work Hours/Work Related Stress
Lack of Knowledge
Nutrition/Diet
School/University
Lack of Gym/Equipment
Are you interested in In-Person Coaching or strictly Online? 💻
In-Person
Online
Please enter your email 📧
example@example.com
Please enter your Phone Number (for whatsapp) 📞
Please enter a valid phone number.
Format: (000) 000-0000.
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