Bilt Wellness | Getting Started Questionnaire & Waiver

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Getting Started Questionaire

Full Name

Phone

Age

Height

Weight

What is your body fat range? Please use the picture scale below for reference

How active is your job or daily routine?

How often do you lift weights?

1-2x per week

3-4x per week

5-7x per week

I currently do not lift weights

How often do you perform cardio exercise? (Walking, Running,Spinning,etc.)

1-2x per week

3-4x per week

5-7x per week

I currently do not do cardio.

Which Bilt Wellness services are you interested in?

Personal Training

The 90-Day Transformation Program

Meal Prep Delivery

Bilt Supplements

Yoga

Group Fitness

All Of The Above

As you embark on your wellness journey, what specific goals do you aim to accomplish within the next 3-months?

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

Date of Birth

Please specify any injuries we should be aware of.

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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