Stronger Together Enrollment Form:4 Week Intro Name * First Name Last Name Pronouns Email * Phone * Country (###) ### #### CURRENT EXERCISE ROUTINE How often do you currently exercise? How often would you like to exercise? Any previous experience with strength training? Have you ever worked with a coach or personal trainer? If so, how was that experience? Current fitness level: Beginner Intermediate Advanced I'm not sure! LIFE STAGE & HEALTH Do any of these describe you? TTC Pregnant Early Postpartum Later Postpartum Peri/postmenopause None If pregnant or postpartum, how many weeks/months? Any pelvic floor symptoms you're experiencing? Any injuries or limitations? Any health conditions that impact exercise? Any negative experience(s) with exercise, dieting or your body that I should know about? FINAL INFORMATION Anything else you'd like Kim to know before we start working together? Release of Liability * can be found at https://www.kimberlysmithmovement.com/releaseofliability I have read, understand and agree to the terms of the release of liability Thank you for enrolling in Stronger Together!
