Maximized Man New Client Kickoff Form
Please answer the following questions to the best of your ability - the more information we have, the better we can assess your starting data, and lifestyle factors
Full name
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First Name
Last Name
Email
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example@example.com
Height
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Current body weight (In lbs)
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Age
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Occupation
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Current relationship status? And do you have kids?
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Give us a detailed description of your goals (fat loss, muscle gain, compete, target areas, timeline). For the most part, fat loss and muscle gain are separate goals so please choose only one.
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What's your "why" for your answer above? This is important. Take a moment to think deeply about it. If/when you hit a roadblock, we're going to revisit this.
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What is your current training regimen like (if any)? And how do you feel it is working for you?
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What fitness programs have you followed in the past (if any)? Why did they work or not work for you?
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What equipment do you have access to? Please be as specific as possible. For example, if you have dumbbells, please list all of the weights that you have. If none, please list "no equipment".
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Do you live in an area where you can for a walk or run outside?
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Yes
No
Other
Please list any prior or current injuries that may affect your workout program.Your answer
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How many days per week are you currently training? (or could you realistically train)
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1
2
3
4
5
6
7
Based on the above question, please choose your preferred workout days based on your lifestyle.
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Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Have you ever tracked your food before using MyFitnessPal?
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Yes
No
How long do you have per day on average to workout? (45 minutes, 1 hour, etc.)
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How long have you been dieting, and what diets have you been using? (If you haven't been dieting, type "N/A")
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If you have been tested for or know of any food related sensitivities or allergies, please list them below.
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Please describe your current level of stress environment. Be as detailed as you are comfortable.
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What are your typical work hours?
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How many hours of sleep do you get per night? (on average)
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1
2
3
4
5
6
7
8+
What time do you normally go to bed and wake up every morning?
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On a scale of 1-10, how would you personally rate your mindset?
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1
2
3
4
5
6
7
8
9
10
How much water do you consume per day (on average)
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Maybe 1 cup per day - I definitely don't get enough
A few cups but I probably should drink more
At least a gallon+
Have you had your testosterone levels checked and if so, what were your levels? (If you do not know your levels, just let us know that below)
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How do you like to be coached?
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What is your address? (We want to send you some free stuff)
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What is your shirt size?
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What is your Birthday?
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Month
-
Day
Year
Date
Add in any important details you think we should know about
Submit
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