Assessment Form

Please fill out the form below. Once submitted please schedule your goal setting call with us!

Full Name*

Email*

Phone - mobile*

Address*

Referred By*

Birthdate (please use the calendar to select your date of birth YYYY-MM-DD)*

Height

Current Weight

Do you have any medical conditions/concerns, allergies, medications that you need to discuss on our call? If you don't wish to list them here, simply answer yes.

List your goals and WHY you want to achieve them. What would it mean to you if you were able to finally reach your goals?

What time do you wake up? Go to sleep?

Describe your daily committments - work, home, family?

How many days a week do you currently exercise? Where do you exercise? What type of exercise do you enjoy most?

Tell us about your nutrition. How often do you eat? What are your go to foods? What foods do you like/dislike? And what is your biggest challenge when it comes to eating healthy?

Please agree to the waiver: CONSENT/WAIVER - By clicking SUBMIT below, I hereby release in full and forever discharge and hold harmless, Strength & Grace Fitness, LLC, CatKlaw, Inc., and its officers, and employees, whether acting within the scope of their employment or otherwise, of any liability, loss, cost, damage, expense, claim, or suit whatsoever for any or all injury, loss, illness, harm, cost, expense, claim, suit, damage or other claim resulting from, related to, or in any way arising from my participation in the following Training/Nutrition programs. I have read the information on these pages and answered all questions on these pages truthfully. I am voluntarily participating in the programs offered by Strength & Grace Fitness, LLC*

Yes

No

Assessment Form

Manage Your Stress and Balance Your Cortisol

Breathwork

The Brownie Cookie

GLP-1: No Shots Needed!

Manage Your Stress and Balance Your Cortisol

Breathwork

The Brownie Cookie

GLP-1: No Shots Needed!