Empowered Woman Form

Welcome to the Empowered Woman
Please complete the questionnaire below with as much detail as possible to ensure
that I can cater your programs specific to you and get you started.

Full Name, Age, Gender & Location

Height, Current Weight & Goal Weight

Email Address

What are your goals? What would you like to achieve from working with Jade?

What do you do for work? How active are you daily?

Are you currently exercising? If yes how many days per week, gym/home, what type of training (weights/cardio/classes) & how long do you train for? And how many days can you commit to training so that I can cater your training program to you? (e.g 5 day weights program).

Please describe your usual daily food and drink intake. (e.g Breakfast: poached eggs on toast, coffee with milk; Snack: Banana; Lunch; Snack; Dinner; Dessert). Also, are you currently tracking macros/calories? If so please list them below.

Please list any food allergies you may have. Please also list any foods you may particularly like or dislike so that I can cater your meal plan to you.

Are you currently taking any medication, vitamins or supplements? Please list here.

Do you have any joint or muscular problems, medical conditions or any other conditions that may affect your ability to train? Please list here.

Thanks for submitting!
I will email you shortly with all the information to get you started. Please be sure to check your junk folder.

Jade x

Welcome to the Empowered Woman Please complete the questionnaire below with as much detail as possible to ensure that I can cater your programs specific to you and get you started.

Welcome to the Empowered Woman
Please complete the questionnaire below with as much detail as possible to ensure
that I can cater your programs specific to you and get you started.