Body Transformation
Form

THE STANDARD STUFF

First name*

Last name*

Email*

Phone*

Address*

YOUR SPECIFICS

Gender*

Male

Female

Age*

Height*

Current Weight*

Desired Weight*

WORKOUT QUESTIONS

Where will you workout?*

At Gym

At Home

Both

Do you have any limiting injuries?*

Yes

No

If yes, please explain.

NUTRITION QUESTIONS

Please list any food allergies.

Any foods you absolutely DO NOT like?

Your preferred method of dieting*

CICO (calories in, calories out - all food in moderation) XLA's recommended method

ALL WHOLE FOODS (nothing processed)

KETO/CARNIVORE (minimal - no carbs)

MEDITERRANEAN DIET (recommended by most doctors for overall optimum health)

PRODUCT PURCHASE

Which product are you purchasing?*

Body Transformation - 6 Week Program$200

Body Transformation - 12 Week Program$350

Body Transformation - 18 Week Program$500

Body Transformation - 24 Week Program$650