New Client Questionnaire -

Congratulations, you've made the 1st step!!!
In order to complete your purchase, ALL Clients are REQUIRED to submit this questionnaire.
We are committed to delivering top-notch individualized plans.
Providing detailed answers allows us to better serve you.

Name *

First

Last

Phone Number *

Address *

Email *

Age *

Weight (pounds) *

Height *

Select Your Body Type *

Naturally Slim: I find it difficult to gain weight. Weight loss/gain fluctuates with diet & workout program. Naturally Muscular: Easy muscle gain with a good diet & exercise program.

Medical History *

If Yes, Please Explain *

Medications (including birth control) & Nutritional supplements *

3 Day Food Journal *

Describe Your Typical Weekly Meals *

I prefer variety I prefer consistency

Describe Your Weekly Workout Routine *

Typical Schedule *

Top 5 Fitness Goals *

Attach Pictures (Rear-Front-Side) *

Max file size: 20MB

I understand and agree to the terms of the Austerus FIT Release/Agreement *

Yes No

Submit Questionnaire

*AUSTERUS FIT RELEASE/AGREEMENT

Click here to upload file
File Size:	176 kb
File Type:	pdf

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