Please fill out this assessment so I can get to know you a little better and see where we need to focus during these next 12 weeks! You'll also be taking this again at the end of the 12 weeks to re-assess where you are.
Click the button below to start.
Question 1 of 34
What's your name?
Question 2 of 34
What's your age?
Question 3 of 34
What is your height?
Question 4 of 34
What are your top 3 fitness goals?
Appearance (aesthetics)
Cardiovascular endurance
Fat loss
Flexibility
Health (general)
Muscular definition
Muscular strength/power
Self-esteem or confidence
Stress reduction
Toning and shaping
Weight loss
Question 5 of 34
What do you weigh right now? If you know your body fat % or muscle mass, let me know those as well. If not, no worries!
Question 6 of 34
What's your target weight?
Question 7 of 34
What size jeans do you wear?
Question 8 of 34
What's your target jean size?
Question 9 of 34
What do you do for a living (job)? What’s your lifestyle like? (from morning to night, give me an example of your day to day routines)
Question 10 of 34
What are a few obstacles that might stand in the way of you reaching your goals?
Question 11 of 34
How many ounces of water do you drink daily?
16
32
64
80
100+
I don't know
Question 12 of 34
How many days per week do you eat out?
Question 13 of 34
Do you drink alcohol? If so, how many glasses per week?
Question 14 of 34
Are there any foods you don't like?
Question 15 of 34
Do you have any food allergies? If so, please list below.
Question 16 of 34
Are you taking any medications or supplements? If so please list below.
Question 17 of 34
How many days per week do you workout? Or how many days per week will you commit to working out?
Question 18 of 34
Which days can you commit to working out?
Question 19 of 34
Do you have a steps tracker? (apple watch, fitbit, etc.)
Yes
No
Other
Question 20 of 34
What equipment do you have access to?
Free weights (dumbbells/barbells)
Cable weights
Resistance bands
Bosu ball
Stability ball
Kettlebells
TRX bands
Battle ropes
Gym (all of the above)
Question 21 of 34
Do you have any medical conditions, injuries or areas of pain? If so please be specific.
Question 22 of 34
Rate your current level of confidence about your body on a scale from 1-5 (1 being not confident at all and 5 being VERY CONFIDENT)
Question 23 of 34
On a scale of 1-10, rate your energy level. (10 being I feel great)
Question 24 of 34
On a scale of 1-10, rate your overall quality of sleep. On average, how many hours per night? (10 being I feel great)
Question 25 of 34
On a scale of 1-10, how stressed are you on a daily basis? (10 being I feel great)
Question 26 of 34
On a scale of 1-10, rate your mental focus and clarity (brain fog, forgetting things, trouble concentrating). (10 being I feel great)
Question 27 of 34
On a scale of 1-10, rate your digestive health (bloating, belching, gas). (10 being I feel great)
Question 28 of 34
On a scale of 1-10, rate your skin condition (dry, acne, breakouts, oily). (10 being I feel great)
Question 29 of 34
On a scale of 1-10, rate your pain (headaches, joint pain, muscle aches). (10 being I feel great)
Question 30 of 34
Tell me about a time when you worked with a coach you liked. What did you like about it?
Question 31 of 34
Tell me about a time when you worked with a coach you didn't like. What didn't you like about it?
Question 32 of 34
How much do you make on a monthly basis? (average month)
Question 33 of 34
How many hours do you work per day? Of those hours, how many of them are productive?
Question 34 of 34
Is there anything else you want me to know?