Flex Ed Intake Form Flex Ed Intake Form Name*City, State, Zip*Email*Phone Number*Gender*MaleFemaleDate of Birth* Age*How Did You Hear About Flex Ed Macros Coaching?Shirt Size in Men's (Only Size Currently Available)XSSMLXLXXLCurrent Weight*Dream Weight*Height*What Are Your Ultimate Goals in 2017 and How Can Working With Flexibledieting.com Help You Achieve Those Goals?*What Would You Say Would Be a Realistic Amount of Time You Would Need to Reach Your Goal?*3 Months6 Months12 Months or MoreWhat Are Your Biggest Struggles in Reaching Your Goals Currently?*How Much Activity Have You Been Doing The Last 1-3 Months?*Do You Have Any Medical Conditions That We Should Be Aware Of?*Have You Done Any "Fad Diets" in the Past?YesNoHave You Ever Tracked Your Macronutrients Before (Protein, Carbs, & Fats)?*YesNoIf yes To The Previous Question, What Were Your Macros Set At & How Long Ago Was That?* This iframe contains the logic required to handle Ajax powered Gravity Forms.