Footer – Fitness with TA

Registration

Name *

Phone Number *

Email Address *

Age *0 / 2

Gender *MaleFemaleOther

Street Address *

City *

State/Province *

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Proceed With Payment

Name: TANU SINGH

Account Number : 50100341725612

IFSC Code : HDFC0001394

Branch : SECTOR 57 GURGAON

Bank Name : HDFC BANK

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Medical Information Form

Age *

Gender *MaleFemaleOther

Height *

Body Weight *

Percentage of Body Fat

Test Needed

Completed Blood Count (CBC)Hormone Panel Including Sex Hormones And ThyroidLipid ProfileGlycoted Hemoglobin (3- Month Mean Plasma Glucose)C-Reactive Protein (Inflammation Marker)Homocystein(inflammation Marker)D3 and B12

Specific to Females - Regularity of Menstrual Cycle, Menopause Information (If Applicable)

Weight Gain during Pregnancy/Lactation Status(Where Applicable)

Past Weight Pattern

Past Exercise Pattern

Current Workout Regularity And Intensity-Both Weight Training Cardiovascular Training

Dietary Orientation

Whether Vegan,Lacto-Vegetarian, Lacto-Ovo vegetarian PescetarianFood Allergies-Intense Dislikes Leading To Nausea

Dietary Recall Of An Average Day, Especially Making Note Of

Meal Frequency /Time Gap Between MealsProportion Of Heigh Thermogenic FoodPre And Post Workout Meals(Type And Quantity)Supplementation Details

Wake Up Time *

Workout Time

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