Gainz Coach Consultation Form
  •  -
  • Gender*
  • Whats the activity level at your job?*
  • Are you experiencing any stresses or motivational problems?*
  • Has anyone of your immediate family developed heart disease before the age of 60?*
  • Do any diseases run in your family?*
  • Do you suffer from diabetes, asthma, high or low blood pressure?*
  • Are you a current cigarette smoker?*
  • Your current diet could be best characterized as:*
  • What following goals does best fit in with your goals?*
  • Are you currently excersising regulary (at least 3x per week)?*
  • Have you trained with a personal trainer before?*
  • At what times during the day would you prefer to train?*
  • Are you willing to invest just $300 per month into finally achieving the body of your dreams?*

  • 1.) ALL THE INFORMATION I HAVE GIVEN IS CORRECT

    All the information on this form is correct and to the best of my knowledge. I have sought and followed any necessary medical advice. I understand that all the information given will be kept confidential.

  • I AGREE TO THE ABOVE TERMS & CONDITIONS!*

  • My Products*

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    1 on 1 coaching . 1 on 1 coaching $300/month
    1 on 1 coaching

    1 on 1 coaching $300/month

    $300.00$300.00
      
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