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First Name *

Last Name *

Phone *

Email *

What’s your current fitness goal? *

Build strength & muscle

Improve energy & overall health

Fat loss & body composition

Other

On a scale of 1–10, how ready do you feel to focus on building consistent, supportive health habits? *

When during your day are you easiest to reach?

Quick-Check

The following questions help us understand where support may be most useful. This is about awareness, not perfection. Every answer helps us build the right next step—together.

Most days, I eat meals that include a solid source of protein and whole foods.

Yes

No

Not Sure

I regularly drink water throughout the day and don’t feel dehydrated most of the time.

Yes

No

Not Sure

I currently do some form of strength or resistance training each week.

Yes

No

Not Sure

I move my body intentionally outside of workouts (walking, mobility, light activity).

Yes

No

Not Sure

I usually wake up feeling rested and able to get through my day.

Yes

No

Not Sure

I have at least one way I regularly decompress or reset from daily stress.

Yes

No

Not Sure

What else do you want me to know about you?

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