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Get expert guidance on fitness and nutrition! Register now for a consultation and start your journey to a healthier you.
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If you're signing up for fitness training, please specify your preferred time.
Enrolling for:
WATER INTAKE (PER DAY):
COOKING MEDIUM (CHOICE OF DIETARY FATS)
FOOD PREFERENCES:
SUPPLEMENTS USAGE: Do you take any supplements / vitamins minerals? If yes please list
Disclaimer - You agree that all the information provided by you is accurate. We don't provide medical aid for any disease nor do we claim to be doctors. This is not a clinical nutrition assistance program, it is intended only for people who do not have any disease and want to lead a healthier life.
Common sense is your best guide when you answer these questions. Please read the questions carefully and answer each one Honestly.
Has your doctor ever said that you have a heart condition and that you should only do physical activity / exercise recommended by a doctor?
Is there any history of heart disease in your family?
Do you feel pain in your chest when you do physical activity / exercise?
In the past month, Have you had chest pain when you were not doing physical activity / exercise?
Do you lose your balance because of dizziness or do you ever lose consciousness, while exercising?
Do you have a bone or joint problem ( for example, Back, Knee, & Hip ) that could be made worse by a change in your physical activity?
Do you suffer from any of the following: Asthma, Diabetes, Epilepsy, High blood pressure etc. because of which your doctor recommended you to not do exercise?
Do you have any other medical or physical condition which may be worsened by physical activity?
Do you have any current injuries or conditions?
If you answered YES to any of the questions above, please check with a doctor once to get clearance to do physical activity.
Terms and Conditions - Disclaimer - Any exercise program, even in healthy individuals, carries risk. You have a responsibility to exercise your own personal judgment, so, you agree that you are voluntarily participating in this physical training. By filling this form, you agree that all the details provided by you are accurate and true. Payment: Clients are required to pay the specified fees for the services provided by KSR Wellness and Digital in advance of receiving any services. Non-Refundable Fees: All fees paid to KSR WELLNESS AND DIGITAL are non-refundable unless otherwise stated in writing by us. This includes but is not limited to consultation fees and training fees.  Transfer of Fees: Fees paid to KSR WELLNESS AND DIGITAL are non-transferable between clients, programs, or services unless explicitly agreed upon in writing by us.
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