Name *

First Name

Last Name

Phone

(###)

###

####

What are your goals? *

Lose Weight/Fat

Gain Weight/Muscle

Maintain Weight

Improve Fitness

Aesthetics Only

Understand Eating Habits

How active is your daily job? *

Sedentary - Desk Job/ Work from home

Lightly Active - Job that requires some standing/moving (Ex: Teacher)

Active - Job that requires lots moving around (Ex: Trainer, Coach, Nurse)

Very Active - Athlete, Construction Worker, Farming/Lifting

How many hours do you sleep a night? *

Very Poor - less than 6 hours

Good - 7-8 hours

9+ Hours

How many litres of water do you drink per day? *

So little, I don't even want to share it

1-2 litres

More than 2 litres

What time do you train?

Before Breakfast

AM

PM

Random

How intense is your training session?

It's ok - I can make conversation

I am breathing hard

Can't talk, busy sweating

Approx, how many calories are you consuming per day? *

Less than 1,000

Between 1,000-2,000

More than 2,000

No idea

Are your family and friends supportive? Are they healthy? *

Not at all

Kind of

Super supportive and healthy

Can you cook? *

Hell no

Simple meals (Chicken/Rice)

I'm a total pro

How well do you cope with stress? Do you eat the stress away? *

I eat when I am stressed

Stress does not effect my diet

I lose my appetite when I am stressed

Check your body type *

Big belly - slim legs

small waist - big booty

Hourglass

Circle

Rectangle

What would best help you reach your goals? *

Recipes & Strict Meal Plan

Macro Coaching

30 Minute Consultation

Other