QUESTIONNAIRE

TRANSFORMATION PACK

Thank you for making the first step towards feeling more healthy, fit and strong with me as your personal online coach! Please take a couple of minutes to fill in this questionnaire so that I can accurately tailor your programming to suit your fitness goals.

Type of Program

Your Sex

Full Name*

Your Email*

Your Height

Your Age

Your Weight

Body Fat (if known)

Training History

What’s your motivation and end goal with your physique and health and fitness?
(i.e. lose weight, bulk up)

Do you currently exercise (Be specific)?

Are you currently following a program?

Do you train am or pm?
ampm

Do you currently have an injuries or illness?

Your training facilities (ie public gym, home)?

How many times do you currently train in a day?

Are you a professional athlete?
YesNo

Are you working with a trainer?
YesNo

What do you think has set you back from achieving your goals in the past?

Are you trying to peak for a specific event?
YesNo

If so please provide date.

What would you rate your daily motivation on a scale of 1 – 10?

Nutrition

Have you dieted before or followed a nutrition plan?
YesNo

Are you allergic to any foods?
YesNo

Please provide an example of a day with your current diet.

Is there any foods you dislike?

Is there any foods you wish to include e.g. favourite healthy foods?

Are you taking any medications?
YesNo

How many meals do you eat per day?

What’s your biggest area you wish to improve on with your nutrition?

Any additional comments you wish to include?

Have you read, understood and agree to the LEGAL DISCLAIMER?
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