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Workout Plan

Name - First Last

What is your gender?

Male Female

Current weight

Current height

What are your specific fitness goals?

Current fitness level

Beginner Intermediate Advanced

Do you have any injuries?

What is your preferred workout environment?

Gym Home Outdoors

If at a home gym what equipment do you have?

How many days a week would you like to dedicate to working out?

What specific areas of the body would you like to improve?

What are some of your current maxes? (if you haven’t done any of the following leave it blank)

Bench Press

Dumbbell, barbell, smith machine?

Dumbbell Barbell Smith machine

Weight

Reps

Squat

Dumbbell, barbell, smith machine?

Dumbbell Barbell Smith machine

Weight

Reps

Shoulder Press

Dumbbell, barbell, smith machine?

Dumbbell Barbell Smith machine

Weight

Reps

Nutrition Plan

What is your typical daily schedule like?

Preferred protein?

Preferred carbs?

Preferred greens?

Current level of daily activity?

light (1-2 hours of physical activity) moderate (3-5 hours of physical activity) heavy ( 6+ hours of physical activity)

Do you have any allergies or dietary restrictions?

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