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Transformation Program
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Transformation Challenge Assessment

General Information

Name

First Last

Email

Phone

Gender

Male

Female

Other

Age

Date of Birth

MM slash DD slash YYYY

Measurements

Weight (kg)

Height (cm)

Waist (cm)

Chest (cm)

Shoulders (cm)

Thigh (cm) - Left

Thigh (cm) - Right

Bicep (cm) - Left

Bicep (cm) - Right

Calf (cm) - Left

Calf (cm) - Right

QUESTIONNAIRE

Please list any food allergies

Select your blood type

A

B

AB

O

Please specify if you have any health conditions, e.g. diabetes

Are you currently taking chronic medication? If so, please specify.

Are you pregnant?

Yes

No

How would you describe your current activity level?

Sedentary

Moderately Active

Active

Highly Active

Do you prefer training at home or in the gym?

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