Client Assessment

Client

Complete this Form Every Four Weeks to Track Our Progress

  • You will receive the data immediately via email
  • Photos are for your personal use
  • Fortitude Fitness will not publish any photos without your consent

 

Client Contact Info.

Your Name

Your Email

Your Number

Self Assessment

Rate Your Current Energy Level from 1-10 (1 being low, 10 high)

Rate Your Daily Performance Level from 1-10 (1 being low, 10 high)

Rate Your Confidence Level from 1-10 (1 being low, 10 high)

Rate How Well You Feel from 1-10 (1 being low, 10 high)

Meal Plan Assessment

Your Age

Your Height (ex. 5.5)

Current Weight

Goal Weight

Current Daily Calories

Body Fat Percentage (Optional)

Body Mass Index (Optional)

Measurements

Neck

Shoulders

Chest

Belly Button

Waist (2" Below Belly)

Hip & Glute (2" Below Waist)

Thigh (10" Above Knee)

Calf

Bicep

Upload Photos

Forward Facing Flexing Biceps

Side Facing Arms Down

Rear Facing Flexing Biceps