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4Star Fitness Information Form

Please answer the questions below and I look forward to connecting with you soon regarding your form!

First Name *

Email *

Where do you feel you need the most help in your journey? (Select all that apply) *

Support, Encouragement, Motivation
Accountability
Guidance and Education
All of the above

How would you classify yourself in your health and fitness journey? *

I am a beginner, never been on a health and fitness Journey before
Starting back into my journey-It has been a while
Other- Please Explain

If other, please briefly explain

How would you classify your current lifestyle *

Sedentary- No Exercise routine
Exercise routine 1 -2 times a week
Exercise routine 2-3 times a week
Exercise routine 3+ times a week

What seems to hold you back from reaching your health and fitness goals? (Select all that apply) *

Procrastination (i.e: not setting priorities)
Always busy- (i.e: Travel, Job, Family)
No Structure/Routine
Barriers or Limitations (ailments, pre-existing injury, hormones)
Habits that are not supportive (junk food, bad relationships/stressful situations)

If you have any barriers/limitations, please briefly explain

Do you have a history of obesity, high blood pressure, cardiovascular disease in your family? *

Father
Mother
Both
Neither

What is your age? *

18-25
25-35
35-45
45-55
55+

What specific goals do you have that you would like to achieve? (Select all that apply) *

Lose Weight
Reshape Body- Muscle Tone
Overall Health- More Energy/Feel Better
All of the above

Any additional comments you would like to share?

Date / Time

Phone

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4Star Testimonials

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Meet Lenore: YOU CAN-cer-VIVE Journey
Meet Ms. Shanda: Set back, to come back!
Meet Mandy: SuperMom x3
Meet Paul: It’s never too late
Meet Maria: Back at It
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NEW CHAPTER IN YOUR JOURNEY BEGINS HERE WITH THE 4STAR FIT AT-HOME BOOK!

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FIT BOOK CONSULTATION VIDEO
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NOURISHING YOUR BODY

NUTRITIOUS AND DELICIOUS OVERVIEW

Nutritious and Delicious Overview

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