NEW YEAR NEW YOU CONSULTATIONPlease complete the following intake form. We will email you with your customized meal plan. Name * First Name Last Name Email * Employer * Phone (###) ### #### Birthdate mm/dd/yyyy Short Term Goals: Long Term Goals Injuries/Medical Concerns Have you worked with a trainer before or taken group classes? Yes No What is your current workout routine? What do you eat throughout a normal day (and water, coffee, tea, alcohol)? How many hours and how well do you sleep at night? Are you stressed? If so, from what? You will hear from us shortly. Looking forward to having you in class!