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Name *

First

Last

Email *

Desired Coach *

Phone Number

Social Media Links

Age *

Height *

Weight *

Training Category *

If you choose "Other", explain in the box below

If you are a competitor, please specify what division (and weight class if applicable)

Have you worked with any trainers / coaches in the past 12 months? If so, please describe your experience.

What does your current diet / meal program consist of? (Please be as specific as possible)

Do you have any food allergies? Have you ever received a 'Food Safe Allergy Test'? If so, please attach.

Have you ever had any issues with disordered eating, body dysmorphia, or been formally diagnosed with an eating disorder? If yes, please explain. *

Do you have any current or past medical conditions and/or issues that we need to be aware of (if so, please include all meds and dosages) *

What kind of natural and/or super supplementation and/or vitamins are you currently using? Please include all dosages, and how many times taken throughout the day.

Have you ever had any nagging pain or injuries that can hinder progress to weight training?

What kind of training and cardio do you do on a regular basis? Please be specific with splits, volume, intensity, duration, etc. *

Do you work out from home or a commercial gym? Are you a morning trainer or evening? Please be specific. *

Please describe the goal(s) you would like to accomplish in the next one to three months. *

Any additional information that you feel would be valuable to your coach?

How did you first hear about Gifted Performance? *

If you chose "Other" or "Coach / Athelte" above, let us know how you heard about Gifted Performance or who you heard from.

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