Name
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First Name
Last Name
Email
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Instagram Handle
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Phone Number
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Age
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Height (Ex. 5'4")
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Weight (lbs)
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Lifestyle or Contest Prep?
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Lifestyle
Contest Prep
Macro Tracking Ability/Experience, If Any
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Lifting experience
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What goal(s) can I help you achieve?
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Do you have a time frame you wish to complete your goal by?
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Provide a detailed description of an average day of your current diet or nutrition information.
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Do you have access to a fully equipped gym? If not, please list equipment that you have access to.
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What are your current macros? (Protein/Carbs/Fats). If not currently tracking, put N/A.
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How long have you been at this caloric intake? If not currently tracking, put N/A.
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Current cardio regimen?
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How has your gym performance been at this intake? If not currently tracking, put N/A.
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Have you been maintaining, gaining or losing weight at this intake? How fast?
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How many "cheat" or "untracked" meals are you currently having on a weekly basis? If not currently tracking, put N/A.
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List any current performance supplements and/or medications that you are taking.
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Female Only: Do you have a regular menstrual cycle? If not, please explain. If so, are you currently using birth control? What kind?
Have you recently received a comprehensive blood panel? If so, please provide the results & list any irregularities.
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Have you ever experienced an eating disorder? If so, please elaborate.
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Have you used or are you currently using any performance enhancing drugs? Please provide a detailed history below as well as response and any issues that may have been present during use. No judgment here.
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Please select which day you'd like to send me your check-ins each week. Check-ins submitted after 12pm PST will be answered the following day. Select a day you can commit to each week.
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Monday
Tuesday
Wednesday
Checkbox
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