Gut Check Coaching
Motivation Is Fleeting. Discipline Is Key.

Complete the forms below so Coach Antonio can build your program around your goals, schedule, and health history. Start with the Consultation form — the Intake and PAR-Q+ come next.

Contact
Your Goal
Personal Information
Goals & Training
Nutrition
Lifestyle
Confirmation
⚠️ You answered YES to one or more questions. That doesn't disqualify you — but please talk with your physician before becoming more physically active. Coach Antonio will discuss this with you and may request medical clearance before programming begins.
Personal Information
Health Screening Questions

The PAR-Q+ is the standard readiness screen used by certified fitness professionals. Answer every question honestly.

01Has your doctor ever said that you have a heart condition or high blood pressure?

02Do you feel pain in your chest at rest, during daily activities, or when you do physical activity?

03Do you lose balance because of dizziness, or have you lost consciousness in the last 12 months?

04Have you ever been diagnosed with another chronic medical condition (other than heart disease or high blood pressure)?

05Are you currently taking prescribed medications for a chronic medical condition?

06Do you currently have (or have you had within the last 12 months) a bone, joint, or soft-tissue problem that could be made worse by becoming more physically active?

07Has your doctor ever said you should only do medically supervised physical activity?

Medical History

Any surgeries in the past 5 years?

Declaration & Signature