Getting Started Worksheet

This worksheet is designed to help me get to know you and your fitness & lifestyle goals more intimately.  Please respond to each section.  Feel free to use as much space as you need to answer each question completely.  The more detail I have, the better!  All information will be kept confidential.

Once I receive your completed worksheet, I’ll review it and use it as a basis for our kick-off assessment session.  If you have any questions along the way, please feel free to email me at Annette@AgelessWithAnnette.com or call (831) 204-8204.

 Ageless with Annette

Basic Contact Information

Ageless with Annette

Connection Preference Information

Our coaching sessions will be done via the web. You will need to have a laptop or tablet and one of the following (free) apps uploaded to your computer. Please choose which virtual platform you prefer for our coaching sessions and provide your contact info:

Ageless with Annette

Basic Health Information

Ageless with Annette

Pre-Participation Health Screen

*Note: if you answered YES to one or more of the above questions, it is strongly recommended that you obtain your physician's approval prior to beginning a progressive exercise program.

Ageless with Annette

About Your Fitness and Lifestyle Goals

What is your single biggest challenge with regards to:

What is your biggest fear or frustration in your life right now related to:

Ageless with Annette

Ageless with Annette

Informed Consent

By signing this document, I acknowledge that I have voluntarily chosen to participate in a coaching program that will include progressive physical exercise. I fully understand that physical exercise can be strenuous. I accept all responsibility for my health and any resultant injury or mishap that may occur from not following the coaching guidelines. I hold harmless of any responsibility, the coach or any persons involved with this program.

By signing this document (type in full name), I acknowledge that all coaching sessions will be paid in advance and that any cancellations with less than 24-hours notice will not be eligible for a refund.

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