Orientation form Orientation Application Form SERIOUS STRENGTH. REGULAR PEOPLE. Your starting point In years mm/dd/yyyy Indicate feet/inches Indicate lbs Gender * MaleFemale Indicate method used. At nipple line. Please indicate inches At navel. Please indicate inches At widest part. Please indicate inches Please provide City & State / City & Country Your goals Please describe your primary short- and long-term goals in regards to training, body weight/body composition, and performance. Are you currently preparing for any competitions (in any sport)? What is your occupation and work schedule? How much time per week do you have available to train (i.e, any major time constraints)? What is your current training schedule during the week? Your personal records What are your current working weights and all-time personal best lifts for: Your past & present Please describe your training history in detail. If you have it, please link to the last four weeks of your training log below. Please list any current or previous injuries, surgeries, any medical/dietary conditions (diabetes, gastro-intenstinal disease, etc), and any residual limitations you have. It would be a good idea to review a PAR-Q document such as this one to be certain you aren’t forgetting any limitations your coach should know about. Medical Conditions (Nutrition Coaching Only) Type I DiabetesType II DiabetesHeart DiseaseHypothyroidismHyperthyroidismChronic Kidney DiseaseCancerHIV/AIDsIrritable Bowel SyndromeCrohn’s DiseaseUlcerative ColitisHistory of GI surgery (for example, gastric bypass)Rhematoid ArthritisGERDNone If you signed up for Nutrition Coaching, please check any and all conditions that apply to you personally so that we can best pair you with your Nutrition Coach: Please list any medications you take. Diet What does a typical day of eating look like for you on training days and non-training days? Is your eating impacted by your work schedule and/or environment? If so, please elaborate. What does a typical day of eating look like for you on training days and non-training days? Is your eating impacted by your work schedule and/or environment? If so, please elaborate. Tracking * YesNo Do you currently track your macros using a macro-tracking app (like MyFitnessPal?) Current protein/carbohydrate/fat intake (in grams) and calories (if ballpark figure please indicate). Are you currently following a controlled diet? If so, please specify. Approximately how many times have you attempted to lose weight? Food scale * YesNo Do you own a food scale? Weight scale * YesNo Do you own a body weight scale Measuring tape * YesNo Do you own a measuring Tape? What foods do you prefer? Please include likes, dislikes, cultural foods, etc. Please list any food and/or drug/supplement allergies. Please list all current supplements and/or vitamins you are currently taking if applicable. Approximately, how many hours of sleep do you get per day? Equipment Please describe your access to the following: a squat rack with safety pins, barbell, Olympic-style plates (300+lbs for females and 400+lbs for males, in increments of 2.5lbs-45lbs), a bench for bench pressing, chalk for grip, the ability to do pullups, a pulldown cable machine, and fractional plates (.5lbs-1.25lbs). Do you own weightlifting shoes and a lifting belt? If so, what brands/models? Where did you hear about us? * Startingstrength.com / Mark RippetoeArt of Manliness / Brett McKayStarting Strength Online Coaching (FB/Instagram/Twitter)Google / Internet SearchBarbell Logic Social Media (FB/Instagram/Twitter)Barbell Logic YouTube ChannelBarbell Logic PodcastFriday Fahves NewsletterOther Please include any other pertinent information, concerns, or questions you have and we'll get to work! Please leave this field empty.
