Health Screening Form | Fierce Health + Fit

Initial Health Screening

To register for the challenge please fill out the following form

Name

Height:

Email Address

Current Weight:

What is your activity level? (LIGHT ACTIVITY= Light exercise 1-3 days, MODERATE ACTIVITY= Moderate exercise 3-5 days a week or VERY ACTIVE= Intense exercise 6-7 days a week).

In the challenge, what area will you need the most help with (ie: nutrition, portion control, drinking water, technique, sticking to the workouts, etc.)?

Do you have any current physical limitations I should be aware of?

I declare that the info I’ve provided is accurate & complete and that I am healthy enough to participate in the challenge.

Thanks for submitting!