| Name |
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| Email address | |
| | Address |
| |
Street Address |
| |
City |
State/Province/Region |
| |
Postal/Zip Code |
Country |
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Home Phone
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Cell Phone
|
| |
Age
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Gender
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Height
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Weight
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Approximate Body Fat
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Fitness Goals
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LIFESTYLE / PROFESSIONAL ACTIVITY LEVELS
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How would you rate the activity level of your profession, or what you do during the day (non-exercise related)?
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Have you ever followed a specific workout program or diet plan? If so, please explain and please be specific.
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Current workout regiment (please be specific)
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Have you ever had any injuries?
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Are you currently taking any medications?
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Current nutritional program, if any (please be specific)? If you are not currently following a program please note. |
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Please list a sample day's diet
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Meal 1:
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Meal 2:
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Meal 3:
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Meal 4:
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Meal 5:
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Meal 6:
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Meal 7:
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Please include your weekly training and cardio schedule, type of activities and the duration.
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Food favorites
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Any foods that you dislike or are allergic to?
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CONTEST AND COMPETITION INFORMATION
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If you have competed before, what are your previous shows and placings?
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Who have you worked with in the past, both trainer and nutritionist, if any?
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Upcoming contest you have in mind, please list all you would be interested in.
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If you have competed before, please explain in detail what your previous contest prep, both training and nutrition, consisted of. (Please be as detailed as possible)
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If you are a previous competitor, what supplements do you usually or have you taken during your contest prep?
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