Built By Andi - Assessment Form

Assessment Form

Completion time : ±5minutes
Name & Surname

First NameLast Name
Gender
Age
years
Height
cm
Weight
KG
What do you do for a living?
What's the activity level at your job?
Do you follow a regular working schedule, do you work mostly days, afternoon or nights?
How often do you currently exercise ?
Please list the physical activities that you participate in outside of the gym and outside of work:
If you have any diagnosed health problems list the condition(s).
If you are on any medications, please list them.
If you have any injuries history of injuries, please list them.
Are you experiencing any stresses or motivational problems?
Do you have gym access ?
Please note any NB information you feel as though we at 'Built by Andi' need to know about your health :
Your current diet could be best characterized as:
Do you have any food allergies or specific dietary limitations ?
What following goals does best fit in with your goals?
What is your goal with your training?
How long do you want your sessions to be ?
How often are you willing to train a week to reach your goal?
What is currently your biggest challenge/barrier to achieving our goals?
If there was ONE word that best describes you as a person what would that word be ?
Terms & Conditions

1. Disclaimer
Your programme is for general fitness guidance only and is not a substitute for medical advice.

2. Assumption of Risk
By participating, clients accept that all exercise carries a risk of injury. They agree to train within their own limits and inform you of any health issues.

3. Accuracy of Information
Clients are responsible for providing truthful and complete information (health history, injuries, goals, etc.) so the plan can be designed safely and effectively.

4. No Guarantees
Results vary depending on consistency, effort, nutrition, and individual differences. You can’t guarantee a specific outcome (e.g., “lose 10kg in 4 weeks”).

8. Programme Access
Plans are personalised for one client only and cannot be copied, resold, or shared.
I AGREE TO THE ABOVE TERMS & CONDITIONS!
NB: Payment & Confirmation

Once you have completed and submitted your assessment, you will receive an email confirming that your programme is being built.

You will receive a second email & invoice once your programme is ready.
Before receiving your programme, you must pay the R149 fee and send proof of payment to builtbyandi@gmail.com.

Payment reference: Name & Surname

Programmes are non-refundable once delivered.
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Bronze Builder
4 Week plan

149.00 ZAR Quantity
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Total

0.00 ZAR
Email
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Assessment Form

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