Athlete Assessment Form

Name *

Email Address *

Birthday (mo/day/year) *

Phone Number *

Which sport(s) do you play? *

If you listed more than one sport above which sport is your primary sport?

What do you enjoy about the sport(s) you play? *

What do you like least about the sport(s) you play? *

How would you describe yourself? You can include strengths and weaknesses. *

What are your current goals related to the sport(s) you play? *

Do you take any prescription medications? If none enter N/A. *

If you take supplements, list them below. If none enter N/A. *

How many ounces of water do you drink each day? *

Do you smoke? *

What time do you go to bed? *

What time do you wake up in the morning? *

What would you like to focus on during the 1-1 consultation? *