Initial Assessment

Shapemii initial assessment

Note: All information provided is kept confidential and we will NOT sell or share this information with any third party. The purpose of this initial assessment is for us to get a better understanding of who you are and what you truly want. With the data points you provide, we will be better equipped to work with you on each step of the way.

Name *

First

Last

Email *

What is your height?

Please select your height from this dropdown list.

How much do you weigh?

Please select the range from the dropdown list.

How old are you? *

Please select your age from this dropdown list.

What is your ultimate aim? *

Lose weight
Be lean
Reshape my body
Look great
Eat better
Exercise more
Live a longer life

Select all that apply to you.

Do you have any of these medical challenges? *

I had surgery over the last 12 months
I am constantly in pain
My knees hurt
I experience constant headaches
I feel stressed very often
I take medications regularly to ease my pain
Other(s)
I don't have any of these medical challenges

Select all that apply to you.

How often do you eat per day?

Selected Value: 0

Slide the bar to your number choice.

On average, how many hours of sleep do you get per night?

Selected Value: 0

Slide the bar to your number choice.

What category best describes your eating habit? *

I eat whatever I have access to
Although I eat most foods, I avoid junk
Although I eat most foods, I avoid red meat
Although I eat most foods, I avoid junk foods, red meat, and dairy
I'm a vegan

What is your favorite drink of choice in the morning? *

Water
Coffee
Smoothie
Beer
Wine
Liquor
Other(s)

What is your favorite drink of choice during dinner? *

Water
Coffee
Smoothie
Beer
Wine
Liquor
Other(s)

Do you run? *

Do you strength train with weights? *

How do you feel about running longer distances (5+ miles)? *

I love it
I do it because I want results
It's OK
I've never tried to run that long
That will NEVER happen

What is the primary reason you want to improve your health? *

For myself
For my child(ren)
For my partner
For others to see and admire
To prove to people who doubted me
My doctor recommended
Other reason(s)

Please select the one top reason.

If you had to improve one part of your body, what would it be? *

Glutes
Arms
Abs
Waistline
Back
Thighs
Shoulders
Forearms
Calf muscles
Other(s)

Please select the one top muscle.

Do you currently work with a personal (virtual or in-person) trainer? *

Yes
No
No, but I'm considering it

Do you currently wear a smartwatch? *

Yes
No
No, but I'm considering getting one

If you wear a smartwatch, what is your heart rate at rest?

Selected Value: 0

You may skip this question if you do not use a smartwatch. Slide the bar to your number choice.

Do you have any additional comments you will like to share?

Please feel free to share any additional comments in the box above.