Online Consultation Form – Coach Denver GeneralName *Date Of Birth *Height Weight Occupation Email *Phone Address Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeAfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongo (Brazzaville)CongoCosta RicaCote d\'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast Timor (Timor Timur)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalestinian TerritoryPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint VincentSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWestern SaharaWestern SamoaYemenZambiaZimbabweCountry Training ExperienceYears Weight Training? Have you had any previous coaches or personal trainers? (please list) What success have you achieved in the past, and what has been your best physical condition (body fat percentage, body weight, etc) What has held you back from achieving your desired results recently? Current Training & ConsiderationsCurrent weight training program (e.g. Monday - Chest & Triceps, etc) Frequency per muscle, main focus, etc.Current steps output Daily target or weekly averageCurrent injuries or physical limitations Do you have any lifestyle or time limitations? heavy work stress, family considerations, shift workOther sports or physical activity Current Nutrition & ConsiderationsWhat is your experience with flexible dieting? Current macronutrient targets and/or calorie targets, including refeeds Do you prefer meal plans or tracking macros? Rigid Meal PlansTracking MacrosFood allergies or concerns Sample day of eating (food sources, measurements where possible) Supplements Other nutritional considerations Health ConsiderationsHealth conditions/considerations Medications Body Image *I am depressed about my visual appearanceI'm comfortable with how I lookI'm excited to look my bestI am proud of my visual appearanceHunger *Feeling starved, constantly hungryFeeling comfortable, maintaining weightFeeling full, contentFeeling full, struggling to eatEnergy *Very low, performance sufferingReasonableGood, getting strongerGreat, could run a marathonStress *Highly stressedStressed but manageableComfortableLow-stressSleep *Less than 6 hours on average6-7 hours on average8 or more hours on average GoalsShort Term Long Term Current Body CompositionPlease email physique progress photos to physique.formation@gmail.comOther Notes VerificationPlease enter any two digits *Example: 12This box is for spam protection - please leave it blank: