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The
winter
cut &
Strength
PROGRAM
FORM
First name
*
Last name
*
Email
*
Describe your goals (examples: lose weight/fat, gain muscle, improve overall health, improve body composition, feel better, increase energy, improve relationship with food, learn about nutrition/exercise, or other goals).
*
What is holding you back from these goals and eating healthier?
*
List any injuries or health conditions.
*
What do you do for work? Is it a desk job or active job?
*
How active are you in your everyday life?
*
Not Active at all
Lightly Active
Somewhat Active
Moderately Active
Very Active
Age
*
Height
*
Current weight
*
Goal Weight
*
What is your Instagram handle?
Submit
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