Full Name
Email
Height
Age
Weight
Waist line/pant size
What are you goals?
What are your specific focus areas?
How is your diet? Please specify.
Medical History? Any current health issues or past health issues? Diabetes, etc?
What’s your blood type?
Do you have a sensitivity to carbohydrates?YesNo
Any injuries or sharp pains when you work out? YesNo
Do you have an abnormal resting heart rate? YesNo
Family medical history?
Time availability?
What do you like about exercising?
What don’t you like about exercising?
Past exercise history? How often do you exercise now?
What are your hobbies or do you have any sport related hobbies?
Have you been under a lot of stress lately? YesNo
Occupation? And are you sitting or standing?
What obstacles would prevent you from reaching your goals?
On a scale 1-10 how serious are you about achieving your goals? 12345678910
Have you ever worked with a personal trainer/coach before? If so, what was the experience like?
