Subscription – Stronger With Natasha

Ready To Subscribe ? Let us know more about you! *

Full Name *

Email *

Phone *

Gender *

Age *

Which Package are you interested in ? Online Sessions or The Boutique Sessions *

Online Coaching ( Please refer to the packages page for more info ) *

The Boutique ( Please refer to the packages page for more info ) *

Weight *

Height *

Check in Photos BELOW (just like the one's displayed, make sure you're in a bikini/ or shorts & sports bra, 3 separate photos each alone, with a white background. You check in every 10-14 days same angle same lighting same outfit.

FRONT

Click or drag a file to this area to upload.

SIDE

Click or drag a file to this area to upload.

BACK

Click or drag a file to this area to upload.

In order to increase your chances of being successful at achieving your goals, a certain protocol should be followed. Please ensure all your goals are " Smart "
S= Specific (Provide details, how long, how much etc.)
M= Measurable (How will you measure whether you’ve reached your goals)
A= Attainable (Be realistic, set smaller goals)
R = Rewards-Based (Attach a reward to each goal)
T = Time Frame (Set specific dates for goals)

1- Do you have any heart condition? *

Yes
No

2- Do you lose your balance due to dizziness or do you ever lose consciousness? *

Yes
No

3- Do you have any health problems? (diabetes, osteoporosis, high blood pressure, high cholesterol, arthritis, anorexia, bulimia, anemia, epilepsy, respiratory ailments, back problems, etc..)? *

Yes - please specify
No

Health Problems

4- Are you pregnant now or have given birth within the last 6 months? *

Yes
No

5- Have you had a recent surgery? *

Yes
No

Surgery *

6- Do you take any medications? *

Yes
No

Medication *

7- Do you drink alcohol? If yes, How often? *

Yes
No

how often? *

8- Were you overweight as a child? *

Yes
No

On a scale of 1 to 10, how would you rate your present fitness level ? *

Worst to Best

On a scale of 1 to 10, how would you rate your Nutrition ? *

Poor to Excellent

On a scale of 1 to 10, how would you rate the STRESS level in your life ? *

Low to High

How many times a day do you usually eat (including snacks)? *

Favorite food (including home cooked meals, fast food, desserts, name it all) *

Least favorite food (things you prefer not to include in your diet) *

Do you have any food allergies? *

Yes
No

Food Allergies *

Do you prefer to have a home cooked meal in your plan? *

Yes
No

What time you wake up and what time you sleep ? *

How do you spend your off days ? *

How many times a week can you workout? are you looking for a gym training split or a home workout? *

if Other *

How long have u been inactive? And what type of workout u used to do? *

State past and present injuries I need to know about *

What supplements have you taken in the past? *

Do you want to take supplements that might help your goal? *

Yes
No
Other

if Other *

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