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Train
About
BLOG
Staff
Schedule
Reviews
Training Plans
McCohn Muscle Fitness Questionnaire
Name
*
First Name
Last Name
Email Address
*
Phone Number
(###)
###
####
Do you ever feel weak, fatigued, or sluggish?
Yes
No
How many meals do you eat each day?
Do you know how many calories you eat in a day?
Do you eat breakfast?
Yes
No
Are you taking supplements? (i.e. vitamins, amino acids, protein shakes, etc.)
Yes
No
Do you crave sugary foods?
Yes
No
Do you have several cups of coffee to keep you going throughout the day?
Yes
No
Do you often experience digestive difficulties?
Yes
No
Proper nutrition can increase the body’s ability to enhance physical and mental performance by up to 80%. Do you feel that a properly structured nutrition and exercise program would benefit you?
Yes
No
How long have you been exercising?
Have you reached and maintained your goals?
Yes
No
Are you happy with the way you look and your health?
Yes
No
On a scale of 1 to 10, how serious are you about achieving your goals?
Desired Body Fat:
Desired Waist Size:
Desired Weight:
Desired Dress or Pant Size:
How many times per week do you plan to exercise?
Which are you interested in?
Aerobics Classes
Free Weight Training
Cardiovascular Training
Circuit Training
Would you like to:
Increase Muscle Tone
Lose Body Fat
Increase Stamina
Increase Strength/Lean Mass
Improve Overall Health
Thank you! We’ll get back with you shortly!
