Consultation
First and Foremost, thank you for considering joining this amazing team. -Team Poynter - Please be sure to fill out this form in its entirety and include an accurate email address as I will contact you via email in regards to coaching.
Name
First Name
Last Name
Male or Female
Male
Female
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Instagram User Name
Your Referral, if any.
Age
Height
Weight
Occupation: This is important for me to understand if you walk a lot at work are in a high stress environment.
List all Prescription Medicine as well as OTC supplements, vitamins etc
What is your overall fitness goal?
Weight loss/Fat loss
Gain Muscle/ Strength
Lifestyle/ Wellness aka Live healthier
Hormone Rejuvenation
Compete In A Show Soon
Work Toward Doing A Show Later On
Improve Previous Show Placing
What Is The Time-frame of Your Goal
0-3 Months
3-6 Months
6-12 Months
12+ Months
When was your last Comprehensive Blood Panel Ran?
How high are your stress levels, on a scale of 1 to 5 with five being stressed out on a daily basis?
What Does Your Daily Food Intake Consist Of. (Meal Plan or Macro Count: please list foods if applicable.) I need to know something here please, if you aren't sure, then what did you eat yesterday .
How many Fast Food Meals do you have per week?
Please Select
0-4
5-9
10 or more
Select only 1: Macro count where I give you a specific macro(number) to hit per meal or actual meal plan where I leave you no guess work, no searching for what "fits" I tell you exactly what to eat per meal broken down to the ounce & gram
Macro Count
Meal by Meal: No guesswork
My goal is to get you up to 5-6 meals per day, if I start you on 5 meals per day, which meal would be the meal the one you have before weight training if you are eating every 2.5-3 hours. If I wake up at 6am have meal 1 and 630am and I am going to lift weights at 4: Meal 4 would be my meal prior to training. Do not list a time of day, I need a meal number please.
How Strict do you want to start your nutrition
Having a little freedom with added breads, fruits, deli meat perhaps
Just doing whatever the coach thinks is best to get me optimal results that I begin to see within a couple of weeks.
Could you do Fasted cardio which means getting up and doing cardio within 45 mins of waking. This does bring optimal results
Yes
No
Sometimes
Are You Currently Working Out with Weight? If so, How many days per week and do you have a specific training style, such as progressive overload or upper and lower body days?
What type of Facility do you have to train in? (Commercial gym, Home gym, Apt Gym). Home gym: Please List Equipment
If you happen to count your steps per day, what does an average day look like for you.
Have you previously worked with a coach, if so, how was your experience?
Females Only: Do you have a monthly cycle? Are you on Birth Control?
Ladies do you have any of the following symptoms
Irregular cycle
Infrequent Cycle
Heavier than normal cycle
Excess hair growth, stomach, face and potential other areas
Thinning of the hair line
Oily Skin
If you wish to compete & have competed in the past, please send me your last stage shots as well as how did you place, what category etc
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List any other information that you think could relative to your goals.
How committed are you to reaching your goals? On the scale of 1 to 10 with 10 being extremely committed, allowing nothing to get in your way.
If you agree that all the information you have provided is accurate & you agree that no information given by Fitnesspoynters is to be shared on any platform. All documents sent to you are for you only, please do not share with anyone or to social media. Sharing or posting workouts or describing meal breakdowns on social medium is not something I can condone, your training and nutrition program was made for you only. Pic posting of meals etc is 100% ok, training videos work as well, please do not share the info I have given you. Please sign below if you agree with my statement. If you are under the Age of 18, a parent or guardian must sign for you. Scroll down to Submit this form **
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