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Client Application 1:1 Monthly
1
Name
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First Name
Last Name
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2
Email
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example@example.com
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3
I am a
Male
Female
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4
How old are you?
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5
What are your goals?
Lose weight
Maintain weight
Gain muscle
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6
Have you dieted in the last 3 years? Please explain.
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7
Have you ever measured food or used a food scale before?
YES
NO
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8
Do you work out? If so, what do your workouts look like?
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9
Have you ever worked with a coach before?
YES
NO
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