Initial Assessment

This is the first step in become the best YOU!

Please fill this assessment out by being honest & detailed with your answers.

Once you submit I will be in touch within 24 hours.

Name

First Name

Last Name

Fit & Fueled Plan

Please choose which plan you would like to more forward with.

Age

Height

Weight

FITNESS

Current habits

What type of workouts do you currently do, if any?

Give details.

How often do you exercise?

How many days a week? For how long?

How active are you at work?

Scale of 1 (sitting all day) to 10 (hard labor)

Do you have access to a gym?

If so, what equipment do you have?

NUTRITION

Current habits

Are you currently following a specific diet?

If so, explain.

Have you ever counted "macros" or tracked your food before?

If so, what were your numbers.

Do you have any food allergies or intolerances?

If so, please list which ones.

How often do you cook at home? How often do you eat out?

How much alcohol do you drink per week?

How much water do you drink per day?

Do you take any supplements?

If so, please list which ones.

How many hours of sleep do you get per night?

Goals

What are your current goals?

Be as detailed as possible.

What is your biggest obstacle?

When it comes to your fitness & nutrition.

Has anything worked well for you in the past?

Or not worked well? If so, please explain.

Answer this: In 6 months I hope to....