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Coaches Consult Form
Client Name
(Required)
First
Last
Client's Email
(Required)
( Please make sure to use the same email address here as you used earlier in the health form. )
3 complaints with health and wellness :-
Column 1
Column 2
Column 3
3 wants from the program :-
Column 1
Column 2
Column 3
What does the client want to ... ?
Suggested calories [ (goal body weightx 2.2 ) X 12 for fat loss or x 16 for fitness or x 18 for muscle gain ]
Carbs %
Protein %
Fat %
Hidden
Carbs (g)
Hidden
Protein (g)
Hidden
Fat (g)
First Meal
(Required)
06:00
07:00
08:00
09:00
10:00
11:00
12:00
13:00
14:00
15:00
16:00
17:00
18:00
19:00
20:00
21:00
22:00
23:00
00:00
Suggestion / Recommendation
Second Meal
(Required)
06:00
07:00
08:00
09:00
10:00
11:00
12:00
13:00
14:00
15:00
16:00
17:00
18:00
19:00
20:00
21:00
22:00
23:00
00:00
Suggestion / Recommendation
Third Meal
(Required)
06:00
07:00
08:00
09:00
10:00
11:00
12:00
13:00
14:00
15:00
16:00
17:00
18:00
19:00
20:00
21:00
22:00
23:00
00:00
Suggestion / Recommendation
Fourth Meal
06:00
07:00
08:00
09:00
10:00
11:00
12:00
13:00
14:00
15:00
16:00
17:00
18:00
19:00
20:00
21:00
22:00
23:00
00:00
Suggestion / Recommendation
Fifth Meal
06:00
07:00
08:00
09:00
10:00
11:00
12:00
13:00
14:00
15:00
16:00
17:00
18:00
19:00
20:00
21:00
22:00
23:00
00:00
Suggestion / Recommendation
Pre consult meds/supplement :
Allergies
Food they like
Food they dislike
Do the client have any medical issue ?
Any medicine for the same ?
Supplements suggested by us :
What equipment do client have access to?
How many time a week will client be able to do a workout?
How long are they willing to work out?
Workout Program Recommendation
fitcru Weight Loss Program
Easy Muscle Gain Program
Easy Muscle Gain Program
Wellness & Gut Health Nutrition Program
Postpartum Program
PCOS Wellness Program
Sculpt & Tone Program
Ability to perform cardio exercises in time
Client's Profession
Steps Goal every day to be assigned
Habits to be added for stress to be added
Habits to be added for sleep to be added
Habits to be added for water to be added
Suggested start date
(Required)
DD slash MM slash YYYY
Comment (if any)
Get Client Data
Press Button to Fetch Client Health Form Data.
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Name
Email
DOB
Gender
What's your Instagram handle?
Fitness Goals :-
What are your main fitness goals?
What are some other health goals you have?
What is your activity level?
Workout preferences
What is your precise current weight? (As of today on an empty stomach) in kgs
What is your ideal long term weight goal? in kgs
How fast do you want to reach your goal? (approx. months)
Waist in cms?
Height in cms?
What is your approx. Body fat %?
Shoulder in cms?
Hips in cms?
Neck in cms?
Dietery Prefernces ?
Do you have any food allergies ?
What are your favourite foods ?
What are your least favourite foods or foods you avoid ?
Do you smoke?
Do you consume alcohol?
Blood tests image if uploaded.
Link
Please upload any current prescriptions you have ?
Do you have Injuries / Surgeries/ Medical conditions?
Front Image
Link
Side Image
Link
Back Image
Link
Mental & Emotional Health :-
How would you rate your current stress level ?
How offten do you have episodes of emotional eating or binge eating ?
What are your primary sources of stress? (Select all that apply)
What do you do to manage stress? (Select all that apply)
How would you rate your overall mood and mental well-being ?
How do you feel about your current body image ?
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