Wellness/Fitness Evaluation Form
Are you ready to achieve your wellness/fitness goals? This is definitely where you need to be!
Tell me about yourself!
Name
First Name
Last Name
What are your current fitness goals? (select all that apply)
Lose Weight
Gain Weight
Maintain a healthy lifestyle
Eat healthier
What is your gender?
Male
Female
Nonbinary
Phone Number*
About how much do you exercise on a weekly basis?
Little or no exercise
1-3 times a week
4-5 times a week
Daily
Which plan are you interested in doing?
Workout Plan
Meal Plan
Lifestyle Plan (Training & Nutrition)
Give a general breakdown of what your current diet/meal plan looks like. (answer only required if you are getting a meal plan.)
Do you have any allergies or food you just do not eat? (answer only required if you are getting a meal plan.)
Are you ready to achieve your goals??
Let's do it!
Not yet.
Email Address
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