Confirm Full Name *

First Name

Last Name

Available Equipment: *

In addition to bodyweight exercises, I have access to:

Resistance Bands with Handles

Booty Bands

Dumbbells

Suspension Straps (TRX or Similar)

What days of the week would you like to exercise? *

Select each day you like us to assign a workout for, Days you don't select will be rest days. For small goals or maintenance, select at least 3 days For large goals, select 4-6 days

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Trainer Recommendation

Medical Conditions *

Check the box if you would answer yes to any of these questions:

Has your doctor ever said that you have a heart condition and that you should only perform physical activity recommended by a doctor?

Do you feel pain in your chest when you perform physical activity?

In the past month, have you had chest pain when you were not performing any physical activity?

Do you lose your balance because of dizziness or do you ever lose consciousness?

Do you have a bone or joint problem that could be made worse by a change in your physical activity?

Is your doctor currently prescribing any medication for your blood pressure or for a heart attack?

Do you know of any other reason why you should not engage in physical activity?

High Blood Pressure?

Diabetes?

Arthritis?

Asthma?

Back Pain?

Knee Pain?

Shoulder Pain?

Depression?

None of the Above

If you answered YES to any of the above please answer the following:

Check the box for Yes Leave blank for No Skip If you did not answer Yes to any of the questions in the previous section

Have you consulted your physician regarding increasing your physical activity and/or performing a fitness assessment?

If you answered NO to the above question, will you consult your physician prior to increasing your physical activity and/or performing a fitness assessment?