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What is your current occupation?
How would you describe your activity level at job?
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Current Body Weight
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About how many hours do you sleep at night?
Is that sleep interrupted? (If yes, please elaborate)
When you wake up in the morning, how would you describe your energy?
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If other, please explain:
About how much water do you consume daily?
Do you consume alcohol? If so about how many drinks per week?
Do you smoke? (cigarettes, cannibus, vape, etc.)
Please describe your typical day of eating (The more detail the better)
Have you had any injuries, current or past, that required surgery or physical therapy? If so please list them all.
How often do you strength train?
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How often do you perform cardio?
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Do you do any other forms of exercise? If so please list them all.
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