Team Juggernaut Personal Assessment Form



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Full address with city, state and ZIP code.
What days are you available to participate in the program? (check all that apply)
What times are you available to participate in the program? (check all that apply)
Please briefly describe (being realistic) your training goals and expectations.
How would you rate your motivation towards your training goals?
Are you satisfied with your current weight? If not, what body weight would you like?
Are you motivated enough to follow an intense training regime for up to 3 months with a monitored diet?

What is your sensitivity to stimulants like coffee?
Please use this area to list any foods which you have an allergy or sensitivity to so that we can exclude these from your meal plans.
Please use this area to list any foods which you just simply will NOT eat.
Can you prepare healthy foods at home or do you absolutely require food convenience?
Please use this area to list your top 5 favorite "junk foods".
Would you describe yourself as chubby, skinny or average as a child?
How many months are you ready to spend to achieve your objectives?
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