Welcome

1

Full Name

First Name

Last Name

2

Date of Birth

Date

3

Email

example@example.com

5

Besides weight loss, what other fitness objectives do you hope to achieve through this program?

Improved cardiovascular endurance

Increased strength

Stress relief

Better coordination and balance

6

What is your preferred time of day for workouts?

Early morning

Mid-morning

Afternoon

Evening

7

How would you describe your current physical condition?

Sedentary (little to no exercise)

Lightly active (light exercise 1-3 days/week)

Moderately active (moderate exercise 3-5 days/week)

Very active (hard exercise 6-7 days/week)

8

What potential obstacles do you foresee that might hinder your progress in this program?

Lack of time

Work commitments

Family responsibilities

Social obligations

Lack of support from family/friends

10

How would you describe your current eating habits?

I eat whatever I want, whenever I want

I try to eat healthy but often give in to cravings

I follow a balanced diet most of the time

I strictly adhere to a specific diet plan

11

What has been your biggest challenge in achieving your fitness goals in the past?

12

Do you have any existing medical conditions or injuries that may impact your participation in this program?