Intake Form (Self-Guided Programme)Complete the form below to get started with your program ASAP. It should only take 3-5 minutes."*" indicates required fieldsName* First Last Email*The email address you purchased with (Note: this will be your username for logging in too) Where are you now?Age*Just a number.Please enter a number from 18 to 99.Height*Select from the drop down box.4 ft 10 / 147cm4 ft 11 / 150cm5 ft 0 / 152cm5 ft 1 / 155cm5 ft 2 / 157cm5 ft 3 / 160cm5 ft 4 / 163cm5 ft 5 / 165cm5 ft 6 / 168cm5 ft 7 / 170cm5 ft 8 / 173cm5 ft 9 / 175cm5 ft 10 / 178cm5 ft 11 / 180cm6 ft 0 / 183cm6 ft 1 / 185cm6 ft 2 / 188cm6 ft 3 / 191cm6 ft 4 / 193cm6 ft 5 / 196cmWeight in Kg*Must be in kilograms without units e.g. 80.1. Click here to see stone to kg conversion table (opens in new window).Please enter a number from 40 to 200.Dress size*If you’re between two, pick the bigger of the two as it gives you more room for improvement 🙂302826242220181614121086How many workouts are you used to doing per week?* None 1-2 3-4 More than 4What's your average daily step count been over the past month?Check either the health app on your phone or smart watch if you have one. If you don’t know, leave this blank.Please enter a number from 0 to 50000.Do any of the following apply to you?Tick all that apply. Polycystic ovary syndrome (PCOS) Underactive thyroid (hypothyroidism) History of eating disorders Perimenopause Menopause Hysterectomy Type 1 diabetes Type 2 diabetesAre you taking HRT?* Yes NoHealth AssessmentRegular physical activity is fun and healthy, and increasingly more people are starting to become more active every day. Being more active is very safe for most people. However, some people should check with their doctor before they start becoming much more physically active. If you are planning to become much more physically active than you are now, start by answering the seven questions in the box below. If you are between the ages of 15 and 69, the PAR-Q will tell you if you should check with your doctor before you start. If you are over 69 years of age, and you are not used to being very active, check with your doctor. Common sense is your best guide when you answer these questions. Please read the questions carefully and answer each one honestly: check YES or NO.Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?* Yes NoDo you feel pain in your chest when you do physical activity?* Yes NoIn the past month, have you had chest pain when you were not doing physical activity?* Yes NoDo you lose your balance because of dizziness or do you ever lose consciousness?* Yes NoDo you have a bone or joint problem (for example, back, knee or hip) that could be made worse by a change in your physical activity?* Yes NoIs your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart conditions?* Yes NoDo you know of any other reason why you should not do physical activity?* Yes NoIf you answered YES to one or more questions: – Talk with your doctor by phone or in person BEFORE you start becoming much more physically active or BEFORE you have a fitness appraisal. Tell your doctor about the PAR-Q and which questions you answered YES. – You may be able to do any activity you want as long as you start slowly and build up gradually. Or, you may need to restrict your activities to those which are safe for you. Talk with your doctor about the kinds of activities you wish to participate in and follow his/her advice find out which community programmes are safe and helpful for you. If you answered NO honestly to all PAR-Q questions, you can be reasonably sure that you can: – Start becoming much more physically active – begin slowly and build up gradually. This is the safest and easiest way to go. – Take part in a fitness appraisal – this is an excellent way to determine your basic fitness so that you can plan the best way for you to live actively. It is also highly recommended that you have your blood pressure evaluated. If your reading is over 144/94, talk with your doctor before you start becoming much more physically active.Digital Signature*I have read, understood and completed this questionnaire. Any questions I had were answered to my full satisfaction. First Last Terms & ConditionsBy signing up for the Fit Over 40 Self-Guided Programme, I confirm that I understand and agree to the following:1. My data will be securely stored and used only for communication between myself and the TRINITY team.2. My data will never be shared with third parties.3. This is a self-guided online programme delivered remotely – not in person.4. This programme does not guarantee results, including weight loss or health improvements.5. The programme materials are for my personal use only. Sharing them with others is strictly prohibited and may lead to legal action.6. Programmes are non-refundable once any personalised content (including email support, custom nutrition targets, or access to streaming videos) has been delivered or made available. This complies with the Consumer Contracts Regulations 2013.7. Programmes cannot be paused. You are expected to continue working on your nutrition and lifestyle even during holidays, minor illness/injury, busy periods, or family challenges.8. This is a rolling monthly subscription. Your payments will continue until you request cancellation in writing and complete the cancellation form (available via the Support button in your online programme at any time). Your monthly fee will not increase as long as you remain a member.9. I have read and agree to the full terms and conditions at: https://trinitytransformation.co.uk/self-guided-terms-and-conditionsDigital Signature*I have read, understood and agree to the Terms & Conditions of this programme. First Last How you found TRINITYWhere did you first hear about TRINITY?* Ad on YouTube TikTok Facebook Instagram Google search From a friend OtherWhat influenced you to join TRINITY?Tick ALL that apply Friend’s recommendation Our daily emails TRINITY podcast Our Instagram posts Our Facebook posts Our TikTok postsWhat's the full name of the friend who referred you to join Trinity?*
