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Welcome to VPT.FIT!
Please fill out and submit this form so we can start creating your workouts! It should only take about 5-10 minutes to complete.
30
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1
Name
*
This field is required.
First Name
Last Name
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2
Email
*
This field is required.
name@example.com
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3
Birthday
*
This field is required.
-
Date
Month
Day
Year
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4
Gender
*
This field is required.
Select
Male
Female
Non Binary
Select
Select
Male
Female
Non Binary
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5
Height
*
This field is required.
Feet
Inches
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6
Weight
*
This field is required.
Pounds
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7
What is your occupation?
*
This field is required.
ie: Teacher, Police Officer
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8
What is the activity level of your job?
*
This field is required.
None (seated only)
Moderate (light activity such as walking)
High (heavy labor)
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9
Do you participate in other physical activities?
*
This field is required.
Fitness Classes, Yoga, Adult Sports Leagues, etc.
Please Select
Yes
No
Yes
Please Select
Yes
No
If yes, please describe.
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10
What are your fitness goals?
*
This field is required.
Check all that apply
Lose Fat
Increase Strength
Increase Speed
Increase Endurance
Improve Stability/Mobility
Build Lean Muscle
Overall Health Improvement
Other
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11
What obstacles do you feel are in the way of your goals?
*
This field is required.
Check all that apply
Lack of time
Lack of fitness knowledge
Lack of motivation
Access to equipment / Limited equipment
Lack of workout space
Finances
None. Let's do it!
Other
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12
What fitness equipment do you have available to you?
*
This field is required.
No Equipment
Full Gym (Planet Fitness, Blink, Crunch, etc.)
Dumbbells
Kettlebell
Resistance Band
Door Hook or similar (to secure resistance band from above)
Door Hook or similar (to secure resistance band from below)
Yoga Ball
Pull Up Bar
Weight Bench
Barbell
Plates
Weight Ball
Squat Rack
Dip Bars
Sliders
Loop Band
Thigh Band
Ab Wheel
TRX
Other
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13
Equipment Detail
Please enter a number
Please Select
Dumbbells
Dumbbells
Please Select
Dumbbells
Please enter a number
Please Select
Option 1
Option 2
Option 3
Please Select
Please Select
Option 1
Option 2
Option 3
Please Select
opt1
opt2
opt3
Please Select
Please Select
opt1
opt2
opt3
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14
Please describe your equipment in more detail
*
This field is required.
How many dumbbells do you have? What weight are each of them? If you go to a public gym, which one? Please be specific! The more information we have, the better we can customize your experience.
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15
If you could, send us pictures of your equipment!
Drag and drop files here
Select files to upload
Max. file size
: 10.6MB
Browse Files
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of
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16
Describe the workout space available to you
*
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17
If you could, send us pictures of your workout space!
Drag and drop files here
Select files to upload
Max. file size
: 10.6MB
Browse Files
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of
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18
How many workouts would you like to complete each week?
*
This field is required.
This is how many workouts you will receive each week. You can change this at any time!
1
2
3
4
5
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19
How many minutes would you like each workout to be?
*
This field is required.
You can change this at any time!
Min: 15 Minutes - Max: 60 Minutes
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20
What is your motivation for joining VPT?
*
This field is required.
What is driving you?
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21
How would you rate your level of motivation?
*
This field is required.
1
2
3
4
5
6
7
8
9
10
Pick one
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
Row 0, Column 4
Row 0, Column 5
Row 0, Column 6
Row 0, Column 7
Row 0, Column 8
Row 0, Column 9
Pick one
1
Row 0, Column 0
2
Row 0, Column 1
3
Row 0, Column 2
4
Row 0, Column 3
5
Row 0, Column 4
6
Row 0, Column 5
7
Row 0, Column 6
8
Row 0, Column 7
9
Row 0, Column 8
10
Row 0, Column 9
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22
How would you describe your ideal coaching style?
*
This field is required.
This gives us an idea of how you would like our coaching team to communicate with you.
Hands Off (Just give me workouts and I'll reach out if I need anything.)
Minimal (Check in once in awhile)
Supportive (Periodic check-ins and encouragement are welcome!)
Accountable (Keep me consistent!)
Strong (I really want you to push me!)
Other
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23
What would you rate your current fitness level?
*
This field is required.
(If you're unsure, pick a lower number)
1
2
3
4
5
If unsure, pick a lower number
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
Row 0, Column 4
If unsure, pick a lower number
1
Row 0, Column 0
2
Row 0, Column 1
3
Row 0, Column 2
4
Row 0, Column 3
5
Row 0, Column 4
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24
How many repetitions of each exercise can you do?
*
This field is required.
Please enter the number of repetitions you can do WITHOUT stopping!
Please enter a number
Please enter a number
Please enter a number
Please enter a number
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25
Have you done AMRAP or HIIT workouts before?
*
This field is required.
AMRAP = As Many Rounds As Possible HIIT = High Intensity Interval Training
YES
NO
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26
Do you have any physical conditions that limit your ability to perform certain movements? (Knee replacement, frozen shoulder, injury, pain, etc.).
*
This field is required.
If so, please describe the pain AND when it is that you experience it (ie. Right knee hurts when I squat too deeply).
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27
Do you have any health restrictions that we should be aware of? (Asthma, heart condition, medications, etc.).
*
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Please list below.
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28
What would be your ideal start date?
*
This field is required.
Must pick a Monday, and must be at least 5 days from today.
-
Date
Month
Day
Year
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29
How did you find VPT?
*
This field is required.
Instagram
Facebook
Youtube
Online Search
Online Ad
Referral from a friend or family
Podcast
Other
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30
Anything else you would like to ask or share with us?
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31
VPT.FIT is run entirely online through email and our mobile app. By hitting SUBMIT, you are giving VPT.FIT permission to communicate with you through these channels.
*
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I understand
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32
Terms of the Liability Waiver
*
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