Health History Name * First Name Last Name Email * List any medical conditions or Injuries List any current medications Substance usage Please describe relationship with caffeine, alcohol, tobacco, etc Current fitness level On a scale of 1-10 how fit are you? Why did you pick that number? Current diet On a scale of 1-10 how healthy is your diet? Why did you pick that number? Current weight, goal weight What is you goal weight and why? Thank you!
