Get Started | AlexandraSomm Fit

About You

First Name *

Last Name *

Email *

Phone *

Age *

Height *

Current Weight *

Occupation *

What You're Looking For

Which service are you interested in? *

Personal Training Nutrition Coaching

Please select at least one option.

What are your current physical and physique goals? *

How long have you been trying to make this lifestyle change? Have you worked with a coach before? If so, what was the plan, and what worked or didn't? *

Health

This health information is used only to design a safe, appropriate program for you. It is never sold. See the Consumer Health Data Privacy Policy.

Physical Activity Readiness (PAR-Q)

1. Has a doctor ever said you have a heart condition and should only do physical activity recommended by a doctor? *

Yes No

2. Do you feel pain in your chest when you do physical activity? *

Yes No

3. In the past month, have you had chest pain when you were not doing physical activity? *

Yes No

4. Do you lose your balance because of dizziness, or do you ever lose consciousness? *

Yes No

5. Do you have a bone or joint problem that could be made worse by a change in your physical activity? *

Yes No

6. Is a doctor currently prescribing medication for your blood pressure or a heart condition? *

Yes No

7. Do you know of any other reason why you should not do physical activity? *

Yes No

If you answered YES to any question, I'll ask for written clearance from your doctor before we start training.

Do you have any existing health conditions or take any medications? Have you had any surgeries or major injuries? *

Do you have any allergies or food intolerances? *

Training

What's your current fitness level, and what does a typical week of physical activity look like? *

How long have you been working out, and what does your current routine/split look like? *

Do you have access to a gym and equipment? Do you do group classes or anything besides strength training? *

Nutrition

How would you describe your current eating habits? Do you follow a specific diet? How many meals do you eat a day? *

Share a few example meals from a typical day, plus favorite foods and foods you'd like to avoid. *

Have you tracked calories before? If so, what was your typical intake range? *

Lifestyle

What does your typical weekly schedule look like? How many hours of sleep do you usually get? *

Anything Else

Is there anything else you think is important for me to know about you and your goals? *

Let's Get You Started

About You

What You're Looking For

Health

Physical Activity Readiness (PAR-Q)

Training

Nutrition

Lifestyle

Anything Else

Got it. Thank you!