8 Week Summer Shred
BenRogersFit
Name
First Name
Last Name
Contact
Phone Number
Email
Birthday
-
Month
-
Day
Year
Date
Please briefly explain your current training regime:
Please list at least 2 of your Fitness related goals
Have you experienced any injuries? If so, how have they affected your training?
Please briefly describe what did you day to day diet consists of:
Nutrition
Please rate your nutrition and food tracking on an average day:
Bad at it
1
2
3
4
Great at it
5
1 is Bad at it, 5 is Great at it
Training
How hard would you say you train?
Low Effort
1
2
3
4
I Train Really Hard
5
1 is Low Effort, 5 is I Train Really Hard
Do you follow a training plan?
Yes
No
What difficulties do you face with your training?
Goal Progression
Rate your progression for the past 12 weeks:
Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
What do you think is holding you back from progressing towards your current goals?
Lifestyle Factors
Please rate your sleep quality for the last week:
Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
Please rate your energy throughout the day:
Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
Do you want to give additional details regarding your lifestyle?
Submit
Should be Empty: