Client Questionnaire
Thank you for the chance to work with you. Your results are also my results! I'm excited to be part of your journey, to help you get you started please fill in your details below.
First Name
Last Name
Email
Instagram
Phone Number
Date of Birth
Age
Height
Weight
What is the best way to contact you?
What is your occupation?
Whats the activity level at your job?
None (Seated only)
Moderate (light activity such as walking)
High (heavy labor, very active)
Do you have any pre-existing medical conditions or injuries?
What is your short term goal?
What has been your biggest obstacle with achieving these goals?
What is your current experience with nutrition?
What is your budget for food each week?
Do you eat lots of greens on a daily basis?
Never
Rarely
Occasionally
Always
Do you track Macros? If YES what is your current target?
Do you consume alcohol? If so how many times per week?
Are you a current cigarette smoker? If so how many each day?
How often do you make eating decisions you regret?
Never
Rarely
Sometimes
Often
Very often
How would you rate your sleep quality?
Very poor
Poor
Average
Good
Very Good
How would you rate your energy levels when you wake up in the mornings?
Very poor
Poor
Average
Good
Very Good
On a scale of 1-10 what would you rate your general level of anxiety/stress?
Do you have have an Apple Watch or Fitbit?
What is your current experience with training?
Never Trained Before
1-3 Years
4-6 Years
7 Years +
How many days can you commit to training?
In terms of training what exercises are your strength and weakness?
Do you track STEPS? What is your daily average step count?
Current Full Day of Eating - Please list all the food you consume in a day
What food do you like and dislike?
What is your favourite foods that you enjoy when eating out?
What obstacles may possibly prevent you from achieving your goals?
What is your why & how will you achieve your ultimate goals?
Please rate your readiness for change on a scale of 1-10
How frequently do you have social outings and dine out?
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