LevelUp Tribe

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First Name and Last Name

Current Plan (please only select one option)(required)

What were your wins this past month? (We want to celebrate all wins, no matter how big or small. What are you proud of; what went well; what did you overcome; what did you do well?)

New Month’s Workout Goals: Do you have any new workout goals, athletic event goals or weight loss related goals you would like to focus in the new month? If so, please explain your goals in detail below.

Fitness Equipment Update: Did you include any new fitness equipment and/or fitness accessories to your tool box this past month? If so, please include in detail what it is, the weight loads, etc.

Mental State: Describe your mental state this past month. Did you feel energized or lethargic? Did you have any new stressor in the last month?

Any out of town travel dates or specific dates that you need adjustments for? If so, list what dates you need off or the dates you will need modified workouts. Please explain in some detail (what days are totally off days, what days you have no equipment access, limited / hotel equipment access, etc.)

Average Nightly Sleep Quality(required)

Great! (8-10 hours)

Not bad (6-8 hours)

Needs work (0-6 hours)

Average Muscle Soreness(required)

Little to none

Manageable

Ah, I'm crippled!

How can I help you MOST RIGHT NOW? Is there anything in particular that you are struggling with that I can help you figure out? It doesn’t have to be food or fitness related. Is there anything you are curious about that you would like to further investigate?

Do you have any questions, comments, concerns or constructive advice for me? Please enter them here. Please number each question separately (1., 2. 3., etc). and include only one question per number.

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