Name: Build My Body Beautiful
Price range: $

Full Name(Required)

Email(Required)

Telephone Number(Required)

Birthday

Height

Weight

Do you know your body fat % - if yes please let us know how it was measured

What is your goal body weight? (also goal body fat%- if you are familer with body fat)

Have you ever worked with a personal trainer in the past? If yes, what was your experience like?

If you work out at home, please list all equipment you have access to?

How many times a week do you do cardio? How long are your cardio workouts and what type of cardio do you normally do?

If you are currently active, what is your current workout split? (ie 3x a week - lower body, upper body, abs + cardio)

Do you have any current or past injuries? Please give us full detail(Required)

On a level 1-10, 1 being the terrible and 10 being perfect, how would you rate your diet in the last 3 months?(Required)

Have you followed (or do you currently follow) a diet program? Please describe below and include any relevant info we may need to know (success/failure etc)(Required)

Do you, or have you ever in the past kept track of your calories, and/or macros?

Do you have a basic knowledge of micronutrients (proteins, carbs, fats)?(Required)

Do you have any food sensitives, allergies or special dietary needs (inlcuding vegan/vegertarian diets)?(Required)

How many meals do you eat per day (snacks included) Ar eyou able to give us an idea what your general day may look like?(Required)

How many meals a week do you eat out/have delivered - please give detail of what you have/order?(Required)

On average how many alcoholic beverages do you consume per week (weekends included)?(Required)

On average how many liters of water do you drink per day?(Required)

Do you take any prescription medications, including birth control? Please list them below

Do you keep you keep track of how many steps you get per day? If yes, what's your avg steps/day #

How many hours of speed do you get per night?(Required)

On a level 1-10, 1 being the low and 10 being the very high, how would you rate your stress level?(Required)

How many hours a day do you spend sitting/working at a desk?

Do you use any supplements? Please list below

On a level 1-10, 1 being the lowest and 10 being the highest, what is your motivation level to reach your fitness goals?(Required)

Are you willing to give us your 100% commitment and trust the process to get you to your goal?(Required)

Is there anything else you would like us to know?

BMBB Application Form

BMBB Questionnaire