Fitness Plan Form
Please reach out to Thewellnessblueprintky@gmail.com with any questions you may have
Name
First Name
Last Name
Email
example@example.com
Contact Number
Please enter a valid phone number.
Format: (000) 000-0000.
How many days a week do you want to exercise?
I don't
1-2 days
3-5 days
6+ days
How much time do you have for a regular exercise?
0-30 mins
30-60 mins
60-90 mins
Depends on the day
Where do you prefer to do exercise?
Gym
Home
Fresh air
Combination
When do you prefer to do exercise?
Early in the morning
In the middle of the day
Afternoon
Evening
What type of exercises do you prefer? (select all that apply)
Cardio
Weightlifting
Low Impact
Crossfit
Other
What is your main goal doing exercises? Select all that apply
Lose weight
Gain weight
Maintain weight
Build muscles
Stay fit
Other
Do you have a partner who you exercise together?
Yes, I have a buddy.
No, I don't.
Current activity level?
Sedentary: desk job, little to no movement
Lightly Active: you work a job with light physical demands, or low physically demanding job with and perform light exercise
Moderately Active: you work a moderately physically demanding job, or low physically demanding job and engage in moderate exercise 4+ times a week
Very Active: You work a consistently physically demanding job, or work a low physically demanding job and engage in intense exercise 5+ days a week
Do you have a nutrition plan?
Yes, I count calories and consume athletics food supplements.
Yes, I count calories but I don't consume any supplemental food.
No, I don't but I eat healthy.
No, I eat totally random.
Do you have any health conditions we should be aware of (injuries, heart conditions, etc.)?
What is the biggest concerns you have when it comes to a fitness plan?
Are there certain types of movement you prefer (ie. walking, hiking, swimming, weight lifting, etc.)?
Anything else I should know in regards to a fitness plan?
Submit
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