Fitnation form

1

Full Name

2

Age

3

Email

example@example.com

4

Phone number

Please enter a valid phone number

5

Do you have any allergies or medical conditions that we should be aware of?* This field is required.

YESNO

6

If yes, please detail

7

Do you have any bone, joint problems, or past injuries that may impact your ability to exercise?* This field is required.

YESNO

8

If yes, please specify

9

Are you currently taking any medications that could affect your performance during workouts?* This field is required.

YESNO

10

If yes, what medications are you taking?

11

Do you have any significant health conditions such as high cholesterol, high blood pressure, heart disease, diabetes, or any other?* This field is required.

YESNO

12

If yes, please specify

13

Has your doctor recommended that you participate in an exercise program?

Yes

No

Not sure

15

Why is this goal important to you?

16

How long have you been working towards this goal?

Less than 1 month

1-3 months

3-6 months

More than 6 months

17

What obstacles have prevented you from achieving these goals in the past?

18

Do you have a support system (family, friends, trainer) to help you reach your goals?

YESNO

19

How many days a week can you commit to working out?

1-2 days

3-4 days

5 or more days

21

Are you looking for a personalized coaching program, or a more flexible program through the app?

In-person coaching

Coaching via app

Both

22

Have you ever worked with a coach before?* This field is required.

YESNO

23

If yes, what type of coaching have you received?

24

What type of workouts do you prefer?

Strength training

Cardio

Flexibility and mobilit

Other

25

Would you like to have ongoing check-ins and support from your coach?

Yes

No

Only at the beginning

26

Is there anything else we should know to help us customize your program?