Wellness Evaluation

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Name* This field is required.
First Name
Last Name
2
Email* This field is required.I will be emailing you a response
example@example.com
3
Phone NumberIf you prefer to be contacted by text please enter your number
Please enter a valid phone number.
4
What is your fitness goal?* This field is required.Select all that apply
Gain muscle
Lose 5-10lbs
Lose 15-30lbs
Lose 30lbs or more
Improve digestion
Improve energy
Boost immunity
Currently Pregnant/Healthy Pregnancy
5
Height & Current Weight* This field is required.
6
Age* This field is required.
7
Do you have any current or previous injuries, health concerns, or any mobility restrictions?Please be thorough!
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How active are you?* This field is required.1 Sedentary - 10 Athletic
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How is your energy on a scale of 1😴-10⚡️* This field is required.
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How many meals do you eat per day?* This field is required.
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What kind of meals do you eat? What do you snack on the most?
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Do you have any dietary restrictions?vegan, gluten free, dairy allergy, etc.
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How much water do you drink?
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How often do you drink caffeine and alcohol?
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How many hours do you sleep per night?
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What diet/behavior changes have you tried before? Why did it not work for you?* This field is required.
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Do you have any specific questions for me?
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By signing this digital form, I agree that ELEV8 Fitness & Nutrition DFW LLC and all parties associated are NOT responsible for any injuries or damages caused during workouts.
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