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Format: (000) 000-0000.
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- Primary fitness goals*
- Biggest priority right now*
- Specific fitness focus areas
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- Types of exercise you currently enjoy
- Do you have a gym membership?
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- How consistent are your current eating habits?
- How many meals do you typically eat per day?
- Which best describes your daily protein intake?
- What is your biggest nutrition challenge?
- Do you have any dietary preferences or restrictions?
- How much water do you typically drink per day?
- What nutrition support would you like?
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- On average, how many hours do you sleep per night?*
- How active are you throughout the day?*
- Approximately how many steps do you currently average per day?*
- How would you describe your current stress levels?*
- How many days per week can you realistically dedicate to exercise outside our group session?*
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- Have you experienced chest pain, dizziness, fainting, or unusual shortness of breath during physical activity?*
- Has a healthcare professional ever advised you to avoid or modify physical activity?*
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- What type of coaching motivates you most?*
- What level of accountability would you prefer?*
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- Are you committed to participating in weekly group workouts and following your individualized plan?*
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- Do you give permission for NIYA to contact you regarding program updates, check-ins, and coaching?*
- Would you be interested in future NIYA fitness programs?*
- How did you hear about The NIYA Method?*
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- Should be Empty: