King Fit Intake Form

King Fit

INTAKE FORM
Full Name

First NameLast Name
Gender
Email
example@example.com
Phone Number

Area CodePhone Number
Where do you live? Time zone
Age
years
Height
Weight
What do you do for a living?
Whats the activity level at your job?
How many pounds would you like to lose/gain, or what is your health goal?
What have you tried before and why did it not work for you?
How many meals do you eat per day?
Which meals are you most likely to skip?
Do you generally snack?
How many days a week do you eat out?
How much water do you drink daily?
What else do you currently drink?
When are you the most tired?

Other
Please rate your readiness for change.
Why?
What do you need the most help with?

Other
Are you willing to financially commit to changing your life?
How do you prefer to be contacted?

Other
I am so excited that you decided to reach out to me to help you with your wellness goals! I can't wait to work with you! I'll reach out within 48 hours!
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