Making the commitment to follow an exercise and diet log is the first step towards healthy living and 3Q Fitness Studio makes it easy.

To help you get started, the following will ask you some basic information that will help gauge where you are and how you should proceed towards your new healthy lifestyle.

Please enter some basic information about you in the spaces provided at the right. This information is required to calculate your various profile indices.

Enter Basic Information:

Age	18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100
Height		(feet)		(inches)
Weight			( pounds)
Gender	Male Female

What is your target weight?

(pounds)

pound(s) per week

By

There are many ways to measure body composition - the approximation of the percentage of fat versus lean muscle mass, bone, blood, etc. We use a circumference based method.

Measurements: Measure the circumference at your waist, neck, and hips (for women) or at the level of the navel (for men). Enter these measurements on the right.

Enter Measurements For

20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60	Waist (inches)
20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60	Navel (M) /Hips (F)
10 10.5 11 11.5 12 12.5 13 13.5 14 14.5 15 15.5 16 16.5 17 17.5 18 18.5 19 19.5 20 20.5 21 21.5 22 22.5 23 23.5 24 24.5 25 25.5	Neck

What is your average daily activity level and lifestyle?
  Sedentary - (inactive)

  Lightly Active - (most professionals, office workers, shop workers, teachers, homemakers)

  Moderately Active - (workers in light industry, most farm workers, active students, department store workers, soldiers not in active service, commercial fishing workers)

  Very Active - (full-time athletes and dancers, unskilled laborers, forestry workers, military recruits in training, soldiers in active service, mine workers, steel workers)

  Exceptionally Active - (lumberjacks, blacksmiths, female construction workers)

Achieving your body composition goals requires both proper diet and exercise. On average, how much time per week do you plan on exercising and being active?

  Light Moderate Vigorous activity for 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 (Hrs)  0 5 10 15 20 25 30 35 40 45 50 55 (Min)

How many times a day do you eat (including meals and snacks)? 1-3   3-5   5-7

Which meal is your largest of the day? Breakfast      Lunch      Dinner

How many days a week do you skip breakfast?  0  1  2  3  4  5  6  7

Do you go too long without eating, causing you to feel "starved" at mealtime? Yes      No

Do you binge during meals? Yes      No

How many times a week do you eat out?

Do you eat fewer than five servings of fruits/vegetables per day? Yes      No

Do you take supplements/vitamins?  Yes      No

Have you tried diet programs or are you currently on one (Weight Watchers, Slim Fast, The Zone, etc.)? Yes      No

Do you need help decreasing the amount of fat and sugar in your diet? Yes      No

Are you allergic to any foods or do any cause you discomfort (cramps, nausea, etc.)? Yes      No

How much water do you drink a day (8-oz. glasses)? 1-3 4-6 7-9 10+

How many times a week do you consume alcohol? 0-3      3-5      5-7

Please enter your name and email to get your fitness analysis results...

	First Name:
	Last Name:
	Email: