Bilt Wellness | Getting Started Questionaire & Waiver

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Getting Started Questionaire

Full Name

Email

Phone

Gender

Age

Height

Weight

What is your body fat range? (Please use th picture scale below for reference)

How active is your job or daily routine?

How often do you lift weights, what is your current routine?

How often do you do cardio, what is your current routine?

Are you interested in a program that helps hold you accountable outside of the gym that will truly change your life?

Please tell us anything else you would like for us to know before getting started.

Thanks for submitting!
We’ll get back to you shortly.

Bilt Wellness Liability Waiver

First name

Last name

Email

Date of Birth

Please specify any injuries we should be aware of.

Please specify your main goal while working with us and anything else you would like us to know before getting started.

Are you ready to commit to a program and reach your goals?

Initials

I declare that the info I’ve provided is accurate & complete

I hereby acknowledge this release from liability for accidental injury or illness which I may incur as a result of participating in any physical activity. I hereby assume all risks connected therewith and consent to participate in this program. I agree to disclose my physical limitations, disabilities, ailments, or impairments which may affect my ability to participate in this program.

Thanks for submitting!

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