PERSONAL INFORMATION

GENERAL INFORMATION

  Body Frame


Small Medium  Large

Activity Level

(Check the appropriate activity level that most closely approximates your lifestyle. Examples:
Sedentary = working behind a PC. Moderately Active = waiting tables. Active = construction work.)

Sedentary Moderately Active Very Active

Body Weight

 Current Weight lbs    Desired Weight lbs

Peak Body Weight

What is the most you ever weighed?     lbs

When did you weigh this amount?    (year)

Body Fat

(Please enter both values if you want calculations to be based on your body fat content.)

Current Body Fat %      Desired Body Fat %

 Days of Activity 

How many days do you exercise?

Personal Goal

Lose Weight   Gain Weight   
Increase Muscle Tone     Cardio Conditioning
Improve Balance Lifestyle Change

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