Health + Fitness Assessment ENROLMENT FORM If accepted into this program, are you ready to go all-in? If your answer wasn't heck-yes, than it's a no. CLIENT NAME * . * HEIGHT: AGE: CURRENT WEIGHT: GOAL WEIGHT: PROVINCE / STATE: OCCUPATION: Email * Phone * INSTAGRAM (secondary form of contact after email) WHAT IS YOUR INITIAL GOAL * MUSCLE GAIN REVERSE DIET CREATE HEALTHY LIFESTYLE/MINDSET WHAT IS YOUR ULTIMATE LONG TERM GOAL? * WHAT HAVE BEEN YOUR BIGGEST OBSTACLES IN ACHIEVING THIS GOAL SO FAR? * WHAT ARE YOUR CURRENT MACROS? (If unsure, please use My Fitness Pal to log yesterdays consumption and provide us with the protein/calorie intake)) * WHICH BEST DESCRIBES YOUR CURRENT ACTIVITY LEVEL: * SEDENTARY LIGHTLY ACTIVE VERY ACTIVE DO YOU HAVE ANY FOOD ALLERGIES, INJURIES OR HEALTH CONCERNS? * DO YOU HAVE THE FINANCIAL RESOURCES AVAILABLE TO COMMIT TO A HIGH LEVEL COACHING PROGRAM SHOULD YOU BE ACCEPTED? * YES NO If you are human, leave this field blank. LET'S GET STARTED!