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Outlaw Fitness
Consultation Form
First Name
Email
Phone
Last Name
Emergency Contact (Name and Phone)
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What program are you interested in?
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If you're a Competitor, Choose yur Division
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Weight
Height
Blood Type
What size shirt do you wear?
Choose size
How active are you? (Rate your activity level 1 work at a desk (teacher, banker, or IT)-5 and 5 being HIGHLY active - work construction work, always on your feet)
What time do you wake up?
What time do you end the day?
What are your fitness goals?
What are your weight goals?
Do you follow a current exercise system? If yes, please list your workout split.
What motivates you?
What time do you workout?
What is your current exercise level?
Have you had any recent weight gain or loss?
Do you currently smoke?
How much alcohol do you consume?
Do you take any vitamins, minerals, or supplements? If yes, please list your supplements.
Do you have any food allergies? If so, list them all here
Please list the type of fruits you like. This will help me personalize your meal plan. (Example: grapefruit, berries and apples)
Please list the type of fruits you like. This will help me personalize your meal plan. (Example: grapefruit, berries and apples)
Please list the type of carbs you like. This will help me personalize your meal plan. (Example: oatmeal, white rice and sweet potatoes)
Please list the type of vegetables you like. This will help me personalize your meal plan. (Example: spinach, green beans and broccoli)
Please list the type of proteins you like. This will help me personalize your meal plan. (Example: chicken breast, salmon and shrimp)
How often do you eat?
Please list any other information that might be useful in preparing a workout routine for you
Are you currently on a special diet or meal plan? If so, write out the plan.
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