Please fill out this form before our next appointment

For scheduling
*Not Required
Example: Sales at a large discount store, I work Monday through Friday from 8-5, I am on my feet all day. We use this to better understand what obstacles to your program may arise.
example: 3 days per week, 2 drinks per occasion
Please list all known allergies and your reaction to each.
Such as heart problems, diabetes, etc. If so, what?
Example: Knee replacement on left knee in 2016.
Do you weight train, do cardio, etc?
Example: I do cardio on an elliptical 3 times per week and do a circuit weight training at Curves once per week.
Are you competitive? Do you walk the course or ride a cart? Do you drink alcohol when you play? How long does it typically take you to play 18 holes?
Stretching, range, weighted clubs, etc.
What time do you wake up? Go to work? Eat? Go to sleep? Are you on your feet all day? Watch much TV? etc.
Please write down what you would eat on an average day, include all meals, snacks, and beverages.
Health, cultural, religious, or other.
This includes fast food
Personal Training

Personal Training

Life Coach

Spiritual Fitness

Golf Training

TPI Golf Training

Mindfulness Classes

Fitness Training for Catholics

Nutritional Consulting

Nutritional Consulting