Bulletproof Labs Hack Tracker
Use this form to track the hacks you perform at Labs, this data will be correlated to your biomarkers and activity for progress tracking.
What Hack did you do?
*
Atmospheric Cell Trainer
Bone Trainer
Brain Charger
Breathe EZ
Cold HIT
EEG Brain Trainer
Flow Chair
Oxygen Trainer
REDcharger
Cheat Machine
The VIBE
Virtual Float Tank
Zona
Body Composition Analysis
Intake Form/Consultation
KETOMETER
Cryotherapy
Baseline Mini
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Atmospheric Cell Trainer
Member
First Name
Last Name
Date
-
Month
-
Day
Year
Date
BioHacker Tech
Jennifer Galardi
Bruce Elebee
Brandon Tobias
Matthew Reed
Christopher Hein
Taylor Smith
Conditioning Profiles
Tier 1-#1
Tier 1-#1 Ext
Tier 1-#2
Tier 1-#2 Ext
Tier 1-#3
Tier 1-#3 Ext
Tier 1-#4
Tier 1-#4 Ext
Tier 1-#5
Tier 2-BGR
Tier 2-BLESS
Tier 2-BMORE
Tier 2-BRG
Tier 2-GBR
Tier 2-GLESS
Tier 2-GMORE
Tier 2-GRB
Tier 2-RBG
Tier 2-RGB
Tier 2-RLESS
Tier 2-RMORE
Tier 3-BGR
Tier 3-BLESS
Tier 3-BMORE
Tier 3-BRG
Tier 3-GBR
Tier 3-GLESS
Tier 3-GMORE
Tier 3-GRB
Tier 3-RBG
Tier 3-RGB
Tier 3-RLESS
Tier 3-RMORE
Tier 4-BGR
Tier 4-BLESS
Tier 4-BMORE
Tier 4-BRG
Tier 4-GBR
Tier 4-GLESS
Tier 4-GMORE
Tier 4-GRB
Tier 4-RBG
Tier 4-RGB
Tier 4-RLESS
Tier 4-RMORE
Tier 5-BGR
Tier 5-BLESS
Tier 5-BMORE
Tier 5-BRG
Tier 5-GBR
Tier 5-GLESS
Tier 5-GMORE
Tier 5-GRB
Tier 5-RBG
Tier 5-RGB
Tier 5-RLESS
Tier 5-RMORE
Tier6-BGR
Tier 6-BLESS
Tier 6-BMORE
Tier 6-BRG
Tier 6-GBR
Tier 6-GLESS
Tier 6-GMORE
Tier 6-GRB
Tier 6-RBG
Tier 6-RGB
Tier 6-RLESS
Tier 6-RMORE
Ear/Sinus Pressure and Comfort
Yes
No
EC-Ear(S) Clear
EB-Ear(S) Block
ED/P-Ear Discomfort/Pain
SD/P-Sinus Discomfort/Pain
OD/P-Other Discomfort/Pain
Ear/Sinus Notes
Client adaptation
Yes
No
Relaxed
Nervous
Using Clearing Method
Discomfort
Body Adaptation
Sipping Water
Client adaptation Notes
Mood
1
2
3
4
5
6
7
8
9
10
Worst
Best
1 is Worst, 10 is Best
Session Notes
Any Additional Hacks?
Yes
No
Submit
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ARX- Cheat Machine
Member
First Name
Last Name
Date
-
Month
-
Day
Year
Date
BioHacker Tech:
Jennifer Galardi
Bruce Elebee
Brandon Tobias
Matthew Reed
Christopher Hein
Taylor Smith
Warm-up /Injuries
Yes
No
Warm-up
Any Injuries
Movements
Incline Press
Horizontal Press
Decline Press
Pec Fly
Triceps Extension
Overhead Press
Calf Raise
Row
Pull Down
High Pull
Shrugs
Biceps Curls
Hamstring Curls
Belt Squat
Dead Lift
RDL
Cheat Machine Notes and Data
Motor Speed%, Exercise Time, Intensity, Max
Session Notes
Any Additional Hacks?
Yes
No
Submit
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Cryo Therapy
Member
First Name
Last Name
Date
-
Month
-
Day
Year
Date
BioHacker Tech
Jennifer Galardi
Bruce Elebee
Brandon Tobias
Matthew Reed
Christopher Hein
Taylor Smith
Blood Pressure
Session Notes
Any Additional Hacks?
Yes
No
Submit
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Body Composition Analysis
Name
First Name
Last Name
Date
-
Month
-
Day
Year
Date
InBody Login
Last time they ate
Bio Hacker Tech
Jennifer Galardi
Bruce Elebee
Brandon Tobias
Matthew Reed
Christopher Hein
Taylor Smith
Session Notes
Any Additional Hacks?
Yes
No
Submit
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Bone Trainer
Name
First Name
Last Name
Date
-
Month
-
Day
Year
Date
BioHacker Tech
Jennifer Galardi
Bruce Elebee
Brandon Tobias
Matthew Reed
Christopher Hein
Taylor Smith
Age
Session Notes
Any Additional Hacks?
Yes
No
Submit
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Cold HIIT
Name
First Name
Last Name
Date
-
Month
-
Day
Year
Date
BioHacker Tech
Jennifer Galardi
Bruce Elebee
Brandon Tobias
Matthew Reed
Christopher Hein
Taylor Smith
Any Injuries
Yes
No
Bike Setting Seat
Bike Handle Setting
Duration
Average Watts
Strides/Minute
Spring Avg. Watts
Program
Cheetah
Athletic
Session Notes
Any Additional Hacks?
Yes
No
Submit
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Oxygen Trainer
Name
First Name
Last Name
Date
-
Month
-
Day
Year
Date
BioHacker Tech
Jennifer Galardi
Bruce Elebee
Brandon Tobias
Matthew Reed
Christopher Hein
Taylor Smith
Starting desaturation Left and right finger.
Left Hand
Right Hand
Service Quality
How long it takes for first desaturation
Standard desat level after sprints
How long for re-saturation after sprints
Seat height A-Q
Seat forward or backwards 1-8
Handle bars height 1-7
Notes
Any Additional Hacks?
Yes
No
Submit
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Bulletproof Intake/Consultation Form
The Art and Science of Becoming SuperhumanAchieve elevated performance with our advanced biohacks
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Name
First Name
Last Name
Date
-
Month
-
Day
Year
Date
BioHacker Tech
Jennifer Galardi
Bruce Elebee
Brandon Tobias
Matthew Reed
Christopher Hein
Taylor Smith
Membership
1 Bullets
6 Bullets
12 Bullets
24 Bullets
Silver Member
Gold Member
Platinum Member
None
CURRENT FITNESS, AND GOALS
What is your MOTIVATION for coming to Bulletproof Labs? What do youwant to accomplish? (Ex: fat loss, muscle gain, train for an event)
What is your exercise history? (Ex: weights, aerobics, yoga, sports)Current activities:Past activities:
How Many times per week
1
2
3
4
5
6
7
PHYSICAL ASSESSMENT
Regular physical activity should be fun, safe, and healthy. Prior to starting a new exercise program, we recommend that you consult with your physician for any potential concerns. Please read the following questions carefully and answer each one by checking YES or NO.
Member building Blockprotocol (primary Equipment)
Yes
BRAINcharger (1)
Breathe EZ
(1)
Body Composition Analysis
(1)
Cold HIIT
(1)
Flow Chair (
1)
KETOMETER
(1)
Oxygen Trainer
(1)
REDcharger
(1)
Vibe
(1)
Zona
(1)
Atmospheric Cell Trainer
(2)
Bulletproof Baseline Mini
(2)
Bone Tainer
(2)
EEG Brain trainer
(2)
Virtual Float Tank
(2)
Cryotherapy
(1)
Cheat Machine (1)
primary quantitative goals
Any Additional Hacks?
Yes
No
Submit
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Baseline Mini
Name
First Name
Last Name
Date
-
Month
-
Day
Year
Date
INBODY
InBody Login
Last time they ate
KETOMETER
Acetone Concentration (PPM)
KCAL/DAY
FAT LABS/DAY
Brain Check
Brain Check Results
Results
Coordination
Cognitive Processing
Reaction Time
Executive Function
Visual Attention
Immediate Recall
Delayed Recall
Any Additional Hacks?
Yes
No
Submit
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BRAINcharger
Name
First Name
Last Name
Date
-
Month
-
Day
Year
Date
Session Duration
Session Notes
Any Additional Hacks?
Yes
No
Submit
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Breathe EZ
Name
First Name
Last Name
Date
-
Month
-
Day
Year
Date
Session Notes
Any Additional Hacks?
Yes
No
Submit
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EEG Brain Trainer
Name
First Name
Last Name
Date
-
Month
-
Day
Year
Date
Session Notes
Any Additional Hacks?
Yes
No
Submit
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Flow Chair
Name
First Name
Last Name
Date
-
Month
-
Day
Year
Date
Session Notes
Any Additional Hacks?
Yes
No
Submit
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Vibe
Name
First Name
Last Name
Date
-
Month
-
Day
Year
Date
Session Notes
Any Additional Hacks?
Yes
No
Submit
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Virtual Float Tank
Name
First Name
Last Name
Date
-
Month
-
Day
Year
Date
Full or Mini
5 Min. Mini
15 Min. Mini
30 Min. Full
Light Setting
Headphone Program
Session Notes
Any Additional Hacks?
Yes
No
Submit
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Zona
Name
First Name
Last Name
Date
-
Month
-
Day
Year
Date
Session Notes
Any Additional Hacks?
Yes
No
Submit
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REDcharger
Name
First Name
Last Name
Date
-
Month
-
Day
Year
Date
Session Duration
Session Notes
Any Additional Hacks?
Yes
No
Submit
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Ketometer
Name
First Name
Last Name
Date
-
Month
-
Day
Year
Date
Acetone Concentration (PPM)
KCAL/Day
FAT Labs/Day
Session Notes
Any Additional Hacks?
Yes
No
Submit
Should be Empty: