New Client Form

Name

First Name

Last Name

Email Address

Phone

(###)

###

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Age

Height

Weight

Chest, Waist & Hip Measurement

Starting body fat percentage % & BMI

Please answer the following questions to the best of your ability. The more detailed information the better!

What is your main purpose for signing up for fitness coaching? (Lose weight, increase lean muscle mass, etc.)

How many days a week do you/can go to the gym?

What is your diet like? If you are not sure, track your food intake for a minimum of 3 days and send in.

What is your schedule like? (What time do you wake up & go to bed, what times do you eat, school, gym, etc)

Are you currently taking any supplements or medications?

Do you have any allergies, health conditions or present/past injuries that I need to be aware of?

Email: nina@ninaditommaso.com