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First Name *

Last Name *

Age *

Email *

What is your main primary goal you want to achieve? *

What is your current experience in the gym training consistently? (Consistent meaning training at least once to twice a week) *

What does your current general nutrition plan look like? *

If "Other", what does your nutrition plan look like?

This program may require calorie/macro tracking to a degree. Are you willing to track or learn how to? *

Do you have any health concerns and/or hormonal concerns? *

Do you have any past/current major injuries? *

Do you have access to a full gym or have a well equipped home gym? (Home gym must include rack with barbell and dumbbells) *

What do you think you need most in order to achieve your goals? (Check all that apply) *

Education and Guidance

Accountability and Consistency

Community Support

Other

If you chose "Other", please specify:

What would it mean to you to achieve your goals? *

Why have you chosen to want to work with Neo Aesthetics? *

On a scale of 1-10: 1 being "I am not confident at all, I will fail" and 10 being "I am 100% confident I will succeed." How would you rate your confidence in accomplishing your goal with this program? *

Neo Aesthetics Coaching requires a minimum commitment of 3 months (though most of our clients choose to stay longer). Are you willing to spend a few hundred dollars per month to make this physical, mental, and financial investment in your health and fitness? *