Fit_Over_40_information

FIT OVER 40

This 60 Day Lifestyle Program will be designed specifically for you and your needs to help you reach your fitness goals and to obtain a healthier lifestyle. This 60 day program will jump start your new healthy and fit lifestyle. Anyone in the Fit Over 40 Lifestyle Program can purchase Training Sessions at a reduced rate.

60 Day Lifestyle Program for less than $3 per day. Receive discounts on Training Sessions when purchasing them with the 60 Day Lifestyle Program. * After purchase, please complete the "Fit Over 40 Consultation" below.

$159.95 - 60 Day Lifestyle Program, Consultation, Fitness Assessment & Personal Training Session

$559.95 - 60 Day Lifestyle Program, Consultation, Fitness Assessment & Personal Training Session. Plus an additional 5 Training Sessions.

$859.95 - 60 Day Lifestyle Program, Consultation, Fitness Assessment & Personal Training Session. Plus an additional 10 Training Sessions.

Fit Over 40 Consultation (Please complete after you purchase the 60 Day Lifestyle Program)

Name:

Age:

Height:

Current Weight & Goal Weight:

Do you have any ongoing medical conditions?

Are you currently taking any medication?

If yes, what are you taking?

How often do you have a bowel movement?

What time do you wake up most mornings?

What time do you normally go to sleep?

Write down your meals, snacks and drinks that you ate the day before. Please include an estimate of the portion sizes.

Are you currently taking any supplements and or vitamins. If yes, please list them.

How many days a week do you drink soda?

Do you smoke?

Do you add salt to your food?

Do you consume white flour?

Do you consume wheat?

Do you consume cow's milk or cheese?

Do you drink beer?

Do you drink wine?

Do you drink liquor?

How often do you eat fast food?

How often do you eat out?

How often do you eat fried foods?

Do you have any food allergies? If yes, what are you allergic to?

Do you currently have a workout routine?

Do you lift weights?

Do you use cardio machines?

Activity level (choose one)

Do you currently have a gym membership?

Is there any additional information regarding your goals that I should know about?

Is there any additional information regarding your health that I should know about?

Email Address

Phone Number