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Flex Fam Initial Assessment

Please fill out this assessment in as much detail as possible. Please note that the answers will not save if you exit the page without submitting them at the end. I'd recommend blocking off at least 20-minutes to complete this! The more detailed you are, the better! :)

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Question 1 of 22

First & Last Name

Question 2 of 22

Email

Question 3 of 22

Phone Number

Question 4 of 22

Shipping Address

Question 5 of 22

Age

Question 6 of 22

Birthday (Month/Day/Year)

Question 7 of 22

Height & Weight

Question 8 of 22

What is your current job/occupation?

Question 9 of 22

Do you have a partner? Kids? Grandkids?

 

If so, do you live with them? How old? 

Question 10 of 22

How did you hear about the Flex Fam?

Question 11 of 22

Do you have any medical conditions (i.e. Heart problems, respiratory problems, chronic illness, etc.)

Question 12 of 22

Are you currently taking any medications? (If so, please list).

Question 13 of 22

Are you suffering from any injuries that impact your daily life or workout abilities?

Question 14 of 22

Do you have any dietary restrictions?

Question 15 of 22

Do you currently track calories and macros (carbs, fat, protein) using a tracking app? If yes, what app do you use? If no, have you tracked macros in the past?

Question 16 of 22

What past diets/eating plans have you tried? What has and what has not been successful (and why)?

Question 17 of 22

How's your relationship with the scale? Do you ever weigh yourself?

Question 18 of 22

What is your current training/exercise program like? (Days per week, duration per session, CrossFit, Orange Theory, running, etc. - the more detail the better)

Question 19 of 22

What are the struggles, deviations, or stressors you currently face with nutrition and training?

Question 20 of 22

What are your goals and desired outcomes from this group coaching program? (Be specific!)

Question 21 of 22

Are you willing to participate in the following activities?

(Select all that apply)
A

Food tracking

B

Weight training

C

Daily Health Tracking (I.e., stress, sleep, recovery, etc.)

D

Progress tracking (I.e., scale weight, body tape measurements, progress photos, etc.)

Question 22 of 22

Please use this section to share anything else you feel is relevant. Thanks!

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