CLIENT PROFILE FORM

"*" indicates required fields

General Information

Name*
Address
What is/are your purpose(s) for participating in a fitness program?*
What services are you interested in (select more than one)*
Define your current level of activity*
How many days per week can you commit to an exercise program?*
Do you have access to equipment at home or at a gym?*

Medical History

Do you have any allergies or medical conditions that we should be aware of?*
Do you or anyone in your family have or have had a history of one or more of the following:*

Goals / Objectives

Ectomorph, Mesomorph, or Endomorph

Complete the following questionnaire to determine your body type.

Nutrition History

How many meals do you eat per day including snacks?*
Are you a...?*
What type of eater are you?*

Daily Meal Snap Shot

Provide a mini journal of your meals each day. Be as clear and honest as possible! We won't judge you:-)