A Holistic Approach to Fitness and Well Being
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  • About You

    All About You! Please tell me all about you. From this information, We’ll be able to establish exactly where you should start. If you are pregnant,have high blood pressure, surgery of any type within the last 2 years, you should have your doctor send a medical clearance. Here is a link to form they can send back to me. See the Doctor’s Medical Clearance for more information. After you fill out the form, a sample plan will be sent to your e-mail. All information that is obtained is completely confidential and will never be sold or given to any other entity.

    First name:

    Last name:

    Date of Birth:
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    mm

    		  

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    yyyy

    Email:

    Address 1:

    Address 2:

    City:

    State:

    Zip:

    Phone:

    Physical Attributes:

    Height (inches)

    Weight (lbs):

    Chest (inches):

    Waist (inches):

    Hips (inches):

    Left Thigh (inches):

    Right Thigh (inches):

    Left Calf (inches):

    Right Calf (inches):

    Biceps Left/Right (inches):

    Left

    		  

    Right

    		  
     

 

September 2010
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