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Complimentary Analysis

My Fitness Profile
1 of 7- Personal Profile Information [required]
* Name:
* Address:
* City:
* State:
* Zip/Post code:
* Phone number & best time to call:
* E-mail:
* Gender:  Male Female
* Birth Date:
* Weight:
* Body fat %:
* Height:
* How did you find us?:
2 of 7- Which Best Describes Your Individual Needs? [required]
Other:
What services do you want a trainer to provide?
Other:
How often would you like to meet with your trainer?
Where would you like to train?
What time would you like to train?
Do you prefer a male or female trainer?
 Male Female No Preference
When would you like to begin training?
Monthly Investment :
Additional Details:
3 of 7- Body Type. Which Best Describes You? [required]
4 of 7- Health & Medical Conditions [required]

5 of 7- Daily Life Questions [required]
What time do you normally wake up?
What time do you normally go to bed at night?
If you smoke, how many years have you smoked?
If you drink alcoholic beverages, what kind and how many per day?
Are you allergic to any types or kinds of foods? If so, what are they?
Have you ever been placed on any type of nutritional program in the past?
If yes, by whom and what did it consist of?
What were your results?
6 of 7- Weekly Exercise Information [required]

Explain in detail what type of resistance exercises, cardiovascular or sports activities you perform on average during a 7-day period. Please also provide the frequency and duration of these activities.

Activity Days Duration (min):

How would you rate the activity level of your profession, or what you do during the day (non-exercise related).
7 of 7- Food Record [required]

Please describe what you eat on a daily average. Include portion sizes (e.g., small, medium, large) any drinks or snacks and vitamins or supplements. Provide as much detail as you like.

Food/Beverage and amount Time of Day

Make a list of your Favorite Foods:

Make a list of foods that you dislike:
Finished
Press the Submit button to forward your profile information to one of our consultants.
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