Please provide the following skinfold measures (in mm):

Abdominal		Triceps
Chest		Mid-axillary
Subscapular		Suprailiac
Thigh

Given the following goals, please click and drag the items into order of importance, with the top being most important and bottom being least important:

• Improved Health
• Increased Muscle Mass
• Improved Endurance
• Fat Loss
• Increased Strength
• Increased Power
• Sport Specific*
• Weight Gain

*Please provide the sport or athletic event for which you are training:

Rate your ability in the following exercises
(check the box that corresponds with your ability):

Exercises	Advanced	Intermediate	Novice	Unfamiliar
Barbell Squats
Barbell Deadlift
Barbell Bench Press
Bent-over Barbell Row
Barbell Shoulder Press
Pull-up
Barbell Hack Squat
Olympic Snatch
Olympic Clean

What do you do for a living?
What is the activity level at your job?
None (seated work only)
Moderate (light activity such as walking)
High (heavy labor, very active)
Does your job involve shift work? Yes No
If you follow a more regular schedule, do you work days, afternoons or nights?

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Are you a primary caregiver for children, individuals with a disability, or an elder relative? Yes No
How often do you travel?
Rarely
A few times a year
A few times a month
Weekly

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Please list the physical activities that you participate in outside of the gym and outside of work. Please provide your most normal daily schedule listing the time you wake up, work and have breaks, work out and go to sleep. Format as [time] - actvity