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Nutrition Program Questionnaire
To ensure we can give you the best
training sessions possible
, please take the time to fill out the information below.
First Name
Last Name
Email
Phone
Birthday
Address
Emergency Contact
Emergency Contact Phone
Profession
How READY are you to change your behaviors and habits?
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How WILLING are you to change your behaviors and habits?
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10
How ABLE are you to change your behaviors and habits?
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Rate your current fitness level.
Pretty bad
Not so good
Good
Very good
Awesome
Rate your current fitness level.
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