Training

I’m ready when you are.

If you want to train with me, just complete the following form to get started. Please be as complete as possible and answer each question honestly.

What are your fitness goals?

Check any which apply from the list below

What are your fitness goals? Check any which apply from the list below

I want to lose weight
I want to gain muscle
I want to improve my diet
I need help getting motivated
I want to train for a sport

If you have other goals not listed above enter them here.

Are you interested in competing in NPC or similar competitions?

Yes
No
Maybe, I will decide later

Name

First Last

Email

Phone*

Address

Street Address City ZIP / Postal Code

Please tell me just a bit more about yourself.

Here is where it really helps if you can be as brutally honest as possible so that I can give you my best advice. Please try to fill in each part as completely as you can.

About yourself:

Your Sex

M
F

Your Age

Your Height

Your Weight

Your Body Fat

Outside of work, how often do you engage in vigorous activity?

Rarely. Once a week, if that.
Sometimes. 1-3 times per week.
Fairly often. 3-5 times per week.
Every day, at least once a day.

What activities do you engage in. (Be specific)

Have you had any injuries that might affect your program?

Yes
No

If yes, please list any injuries here:

Are you taking any medications that could affect your program?

Yes
No

If yes, please list any medications here:

Are you currently working with a trainer or following any weight reduction plans?

Please give any details you can here. Have your diet or training efforts been successful?

Tell me a bit about your eating habits.

What are your favorite healthy foods?

What are your least favorite healthy foods?

If possible, please upload a recent photo or two of yourself.

Max. file size: 128 MB.

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