Your Blueprint Intake · Rich N Relentless

About You

Your name Your emailThe one you paid with, so we can match your order. Gmail for your Google SheetYour training plan lives in a Google Sheet. We share it with this address. Your age Your date of birth

Your 5 Answers

Short is perfect. A sentence or two each.

1. Your goal, in one sentence 2. How many days a week can you train? 3. Where do you train?The gym's name (or home), plus the equipment there: machines, cables, how heavy the dumbbells go, turf, sleds, anything unusual. 4. Any injuries or pain?Write "none" if there aren't any. 5. What's knocked you off in the past?

Your Photos

Underwear or a swimsuit, so we can see what's really changing.
Stand tall, arms relaxed, full body in the frame.
Phone at belly-button height, good light near a window.

Phone photos, not originals. All your photos together need to be under about 8 MB. Photos straight from your phone's camera are fine; large photos are shrunk for you before they're sent. Full photo instructions

All 4 photos are needed for a full 360 view, but you don't have to add them right now. You can submit this form first and email your photos to sixfigurefitacademy@gmail.com (subject: "My Blueprint photos"). Your plan starts once we have all 4. Use the same spot and the same light for each one.

1. FrontFace the camera, arms relaxed at your sides. 2. BackTurn your back to the camera, arms relaxed, same spot and light. 3. Left SideYour left shoulder faces the camera, arms relaxed. 4. Right SideYour right shoulder faces the camera, arms relaxed.

Health Check

Seven yes-or-no questions, based on the PAR-Q+, the standard pre-exercise questionnaire in Canada. You can also fill in the official PAR-Q+.

1. Has a doctor ever told you that you have a heart condition, or that you should only do physical activity a doctor recommends?

YesNo

2. Do you feel pain in your chest when you're resting, or when you're active?

YesNo

3. In the past 12 months, have you lost your balance because of dizziness, or lost consciousness?

YesNo

4. Have you been diagnosed with an ongoing medical condition, other than heart disease or high blood pressure?

YesNo

5. Do you take prescribed medication for an ongoing medical condition?

YesNo

6. Do you have a bone, joint or soft-tissue problem (muscle, ligament or tendon) that could get worse if you became more active?

YesNo

7. Has a doctor ever said you should only do physical activity with medical supervision?

YesNo

Read the full Health note.

Your Consent

I confirm I am 19 or older, or I am 14 to 18 and my parent or guardian agrees and signs below. I agree that Six Figure Fit Academy may collect and store my health answers and photos to build and adjust my plan, as described in the Privacy page. I understand my photos stay private and are never posted or shared without my separate written consent. I understand the Body Blueprint is non-refundable once purchased. I understand that completing the PAR-Q+ health screening and getting medical clearance when needed is my responsibility. I know where to find it (the official PAR-Q+ and our Health page).

Your Signature

I'm under 19.

By signing, you confirm everything above is true and that you've read and agree to the Terms of Sale & Refunds, the Health note and the Privacy page.

Your signature

Draw with your finger or mouse.

Full legal name Date

Your Intake Form

About You

Your 5 Answers

Your Photos

Health Check

Your Consent

Your Signature

Parent or Guardian Consent (if you're under 19)

Thank You. We've Got Everything.