Fitness Assessment Form

NEW 8 WEEK STRENGTH CHALLENGE HAS ARRIVED!

Designed for those who are ready to make serious change in 2025. If you are wanting to increase STRENGTH and build MUSCLE then this program is for YOU!

If you are time poor this program is for YOU!

If you are struggling with plateaus this program is for YOU!

If you struggle with motivation & accountability this program is for YOU!

If you want to reach your goals of increasing strength, this program is for YOU!

Please complete the below questionaire and I will be in touch to organise your 8 week program and nutrtion requirments.
Name*

First NameLast Name
Age
Date of Birth*

MonthDayYear
Date
Email*
example@example.com
Phone Number
Format: (000) 000-0000.
Occupation
Health-Related Questions
Do you have the following conditions?*

AnemiaArthritisAsthmaCardiovascular problemsDiabetes MellitusHypertensionGlaucomaBone problemsRespiratory issuesMigraineOther
Are you a smoker?

YesNo
Are you pregnant (Female only)?*

YesNo
Do you drink alcohol?

YesNo
How many times do you exercise in a day?
Rate your current knowledge of Exercise & Nutrition.*

1 Poor234 Excellent
Do you have any dietary requirements or nutritional requests?*
Rate your current level of fitness.*

1 Unfit2345 Very active
Have you had any previous injuries or medical conditions that may hinder you from exercise? If yes, please indicate.
Which training split would you like?*

3 Day Split (Full Body)5 Day Split (Full Body + Core)
Preferred payment method*

Weekly $40Up front $ 300
I understand & agree to the 8 week commitment POLICY. 8-week commitment policy: When signing up to this challenge, you are committed to a period of 8 weeks. Payments will be direct debited from your nominated bank account weekly or upfront depending on your chosen payment method. This commitment ensures consistency and allows us to make real progress toward your goals.*

I agree.
Client Signature
Date Signed

MonthDayYear
Date
Should be Empty:

NEW 8 WEEK STRENGTH CHALLENGE HAS ARRIVED!

Health-Related Questions