Intake Form Name * First Name Last Name Email * Do you have any medical issues, allergies or injuries? If yes, please list and give additional relevant details. Why do you want a fitness coach? How long have you consistently exercised? If you currently exercise, how many days per week? How many uninterrupted hours of sleep do you get per night? What time do you wake up? What time do you go to sleep? Are you currently or have you ever followed a nutrition program? If so, what worked, what did not and why? How much water, do you drink per day? How would you rate your energy levels throughout the day? (1-10, 1 = Extremely low/10 = Excellent, never felt better) Thank you!
