Online Client Submission Form

Fill out this form so you can start your fitness journey today.

First name

Last name

Phone

Age

Weight

Height

What goal do you want to achieve during this experience?

Do you have a history of weight training and what is your current training program?

What does your diet consist of?

How much water do you consume daily?

What do you do for a living?

Currently, where are your stress levels? (Scale from 1-10, 10 being the worst)

How much-uninterrupted sleep do you get on a nightly basis?

Are you currently dealing with any injuries or dealt with injuries in the past? (Strains, pulls, brakes, tears, surgeries, etc.)

Are you taking any medications or dealing with any health issues?

How many times are you able to go to the gym consistently?

What gym do you train out of and what equipment do you have available at home?

Schedule an appointment

January 2026

Week starting Sunday, January 18

Time zone: Coordinated Universal Time (UTC)Phone call

Wednesday, Jan 21

10:00 AM - 11:00 AM

11:00 AM - 12:00 PM

12:00 PM - 1:00 PM

1:00 PM - 2:00 PM

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