Stronger Together: Core Enrollment Form PERSONAL INFORMATION 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 What best describes you? Pregnant or TTC Early Postpartum Later Postpartum Peri/menopause Other/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? EXERCISE ENVIRONMENT Where will you do your workouts? Home Gym Both Other If you'll be exercising at home, what equipment do you have access to? If you'll be exercising at a gym, do you know what kind of equipment you'll have access to? Preferred number of workouts per week? Preferred workout duration? (ex: 2 longer workouts or 3 shorter workouts, etc) When do you plan to accomplish your workouts? (usually) FINAL INFORMATION What does success look like for you after 4 months? 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!I will be in touch soon with your onboarding info to download and familiarize yourself with the MyCoach app.
