Liv Imperial Fitness Submission Form

Welcome!

I am so excited that you are interested in working with me on your health and fitness goals. I would love to get to know a little bit more about you, your goals, and what you are looking for in a coach and partner to confirm that we are a good fit!
Email*
example@example.com
Name*

First NameLast Name
Age*
Height*
Weight*
Past/ Present Injuries or Health Issues*
Please describe any injuries or health issues you may have suffered or are currently navigating and anything you have done or are currently doing to address them. Please confirm you have been cleared by a medical professional to begin an exercise and/or nutrition program.
Current Medications
What type of plan or coaching are you interested in?*
What goals are you looking to accomplish through a partnership together?*
What things have held you back from accomplishing those goals on your own?*
Do you feel you have a support system and environment that will help you accomplish your goals?*
Describe your past diet history and present nutrition/ eating habits.
Describe any known food sensitivities and preferences.
Have you in the past or do you currently struggle with disordered eating?
Please rate your typical level of stress throughout the week.
1 Being No Stress, 10 Being Extremely Stressed/ Struggling to Manage
Currently, what are your main sources of stress?
On average, how many hours of sleep do you get a night and what are your currently sleep habits like?*
How would you describe your current daily activity level/ training habits?*
How many days a week and how much time can you dedicate to working out?
Equipment

Full Gym MembershipOther
What are you looking for in a coach?*
Anything else you would like to share?
Should be Empty:

Welcome!