Exercise Plan Form ml | Paul Plakas Fitness

Name

First Last

Email

Phone

Information About You Here's what I need to get you started...

Height*

Weight*

Age*

Gender*

What is your weight loss goal?*

What have you been doing for exercise in the past three months?*

Do you have any orthopedic problems, injuries or limitations?*

List the specific fitness goals that want to attain.*

List the specific obstacles you need to overcome that could prevent you from achieving your fitness goals.*

Describe in detail hour by hour what a typical day looks like for you.*

Do you enjoy or have played any sports?*

List any people in your life you think will support you directly and how in achieving your fitness goals.*

List any people that could sabotage your success and how.*

Is there any reason you can not physically exert yourself?*

Are you on any medication? If so please list.*

Do you or have you ever had high blood pressure, heart issues, family history of heart problems, cancer, or any other diagnosed disease?*

Describe the time in your life when you felt you were the fittest. Explain the circumstances.*