Name
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First Name
Last Name
Email
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Phone
You can skip this if you already provided it on another form
(###)
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Date of Birth
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You can skip this if you already provided it on another form
MM
DD
YYYY
What are your training goals?
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Check all that apply
If you want to add a training goal that isn't listed above, or let me know which exercise(s) or body part(s) you want to focus on, please let me know here.
Where do you work out?
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Check all that apply
Do you have access to a barbell and weight plates?
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Do you have access to a squat rack?
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Do you have access to a flat bench?
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Do you have access to an adjustable (incline) bench?
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Do you have access to a pullup bar?
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Do you have access to a suspension trainer (TRX) or rings?
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Do you have access to dumbells?
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If you own or have access to dumbbells, what is their weight range?
Are there any common machines that you do not have access to?
Examples: cable machine, seated cable row, lat pulldown, leg press, leg extension, leg curl, assisted pullup
Are there any less common machines that you do have access to?
Examples: hack squat, V squat, glute-ham raise, reverse hyper, trap bar, multi-grip (football) bar, pullover machine, lateral raise machine, Hammer incline or flat press, Hammer plate-loaded shrug
Do you own or have access to bands? If so, what kind?
Examples: minibands (for knees/ankles), glute loop or Slingshot, handled bands, continuous loop bands. Selection of band thickness? Are there duplicates or just one of each?
How many years have you weight trained?
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How comfortable are you in the gym?
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How proficient would you say you are with basic barbell lifts?
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These are exercises like a barbell back squat, deadlift, bench press, bent-over row, and overhead press.
Please describe your current training program.
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Be specific. Include the number of days you train, how the days are split (body parts or movement patterns), exercise selection, and rep ranges.
What do you like and dislike about your current program?
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Please describe your current cardio training.
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Be specific. Include the type(s) of cardio, duration of each session, and frequency of sessions.
What are your favorite and least favorite exercises?
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List as many as you like—the more the better!
What are your favorite and least favorite body parts to train?
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List as many as you like—the more the better!
Do you have any absolute nos or non-negotiables for your training?
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If so, what are they?
How many days per week are you realistically prepared to train hard?
You can make great progress with pretty much any training frequency, so please make this number a true fit for your life, not a wish. This isn't meant to reflect what you think might be ideal. It's meant to be the number of days can you realistically commit to without missing days. Even if that number is two, let's do it!
Do you have any requests for your program?
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If so, what are they? Or is there anything else you want me to know?
Medical Disclaimer
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Please recognize that it is your responsibility to work directly with your health care provider before, during, and after seeking nutrition and / or fitness consultation. Any information provided is not to be followed without prior approval of your doctor. If you choose to use this information without such approval, you agree to accept full responsibility for your decision.
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