JOIN THE TEAM

Name

First Name

Last Name

desired service

for powerlifting programming, please email alex@fullychargedfitness.net

time zone

Birthday

YYYY

Sex

height and weight

please leave blank if focusing on weight is triggering and you'd prefer to focus on making healthy habits

current activity level

training experience

what days do you work out?

monday

tuesday

wednesday

thursday

friday

saturday

sunday

do you currently do cardio? if so, how many minutes per week?

do you have any injuries or limitations?

if no, please leave blank

current diet

if possible, please include calorie level and macro split. otherwise, please do your best to provide a general description

supplements

please list any supplements or vitamins you currently take

birth control and/or current medications

short term goals

please describe what you would like to accomplish in the next 3-6 months

long term goals

please describe what you would like to accomplish in the next 1-3 years

additional comments/concerns/questions