Log in  \/ 

FREE Basic Health & Fitness Assessment

Whether I am personally training you, or helping you setup a meal and diet plan, the questions below help to create a baseline to measure results from. ALL information you submit is secure and personal NEVER to sold or spammed.

First Name(*)
Please let us know your name.

Last Name(*)
Invalid Input

Phone(*)
Invalid Input

Your Email(*)
Please let us know your email address.

Best time to reach you?(*)
Invalid Input

Age(*)
Invalid Input

Height(*)
Invalid Input

Current Weight(*)
Invalid Input

Ideal/Goal Weight(*)
Invalid Input

How often are you exercising?(*)
Please let us know your message.

Explain below the quality and state of your nutrition (What are you eating and how often do you eat every day):

Nutrition(*)
Invalid Input

What kinds of programs have you tried in the past?(*)
Invalid Input

What results did you experience?(*)
Invalid Input

How long did the results last? Please Explain.(*)
Invalid Input

What are the biggest obstacles to reaching your goals?(*)
Invalid Input

What medical, physical, or other health issues do you have?(*)
Invalid Input

If the above question applies to you, have you been cleared by a doctor for exercise?(*)
Invalid Input

Is there a major event happening in the near future for which you are wanting to get in shape?
Invalid Input

If yes, what kind of event is it and when is it occurring?
Invalid Input

Anything else you would like for me to know?
Invalid Input

Security Captcha(*)
Invalid Input