Initial Questionnaire

Danny Burde

6 years ago

Get the first step started by filling out the initial questionnaire below! You will hear back from us within 24 hours!

Please enable JavaScript in your browser to complete this form.

Name *

First

Last

Email Address *

Confirm Email

What is your PRIMARY fitness focus? (Choose one) *

List any specific, measurable goals. (i.e., run a 6 minute mile, perform 5 Push Ups, get down to 10% body fat, etc.)

Describe your physical exercise over the last 2 months. Please include type of exercise, frequency per week, and duration of each session. *

Describe your athletic background & sports played in the past.

Describe your current nutritional intake.

What gym equipment do you have daily access to? (It's okay if the answer is "none"!) *

Do you have any medical conditions that will interfere with physical activity? If "yes", please list them below.

List any previous serious injuries you've sustained in the past. (i.e., broken wrist, torn hamstring, etc.)

List any injuries or pain you are CURRENTLY experiencing. (i.e., plantar fasciitis, sciatica, elbow tendonitis, etc.)

List any range of motion limitations. (i.e., arm/knee extension, overhead mobility, etc.)

On a scale of 1-10, with 10 being the highest, how motivated are you to accomplish your goals? (Slide the scale left and right)

Selected Value: 0

Website