Application form for the SMART Fitness Makeover™ VIP Experience

Thank you for your interest in the VIP Experience program.

I would be most grateful if you could let me have some information about yourself and your circumstances to help me better understand if we would make a great team, what your goals are and what results you expect to get from the VIP Experience.

Physical exercise is an essential feature of the SMART Fitness Makeover VIP Experience and I therefore need to know that it’s safe for you to exercise at home or at the gym either under my guidance or unsupervised. Please answer all questions truthfully and to the best of your knowledge. There are no right or wrong answers, just your answers.

Please choose one or more options.
Please list any medications prescribed by your doctor
If yes, please give us some details
Please tick all options to confirm
Please type your full name and today's date