General Information
Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Email
*
example@example.com
Phone Number
Please enter a valid phone number.
Instagram Handle
How did you hear about JaLynn Lifestyle?
Height
Current Weight
GOALS
What are your short-term health/fitness goals?
What are your long-term health/fitness goals?
Medical / Health
Do you have any diagnosed health conditions I should be aware of?
*
Do you have any current/past injuries I should be aware of? Any physical restrictions/limitations?
*
Activity
How frequently are you engaging in resistance training each week?
*
1 day
2 days
3 days
4 days
5 days
6 days
7 days
I don't currently engage in resistance training
What is your experience in regard to resistance training?
*
Beginner
Intermediate
Advanced
How many days per week are you willing to commit to exercise?
*
If you looking for a home-based training program, please list the equipment you currently have access to.
What is/are your preferred rest day(s)?
*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Submit
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