NEW CLIENT QUESTIONNAIRE
1.a. What are your top 3 goals? (Most important first)
1.b. Why do you want to achieve these goals?
1.c. How would you feel achieving these? (Be specific)
2. What prevents you or has prevented you from achieving them in the past?
3. What difficulties do you face?
4. What's your current nutrition like?
5. Have you previously tried an diets?
6. How's your current health status?
7. Do you follow a current training programme? If so what is it and how many times per week?
8. What exercise or activities do you dislike?
9. What exercise or activities do you like?
10. What's yur current level of sleep like and how many hours?
11. Is your job sedentary, active or physically demanding?
12. On a scale of 1-10 where would you rate your stress level? (10 being the highest)
13. Do you smoke? If so how many times per day?
14. Do you drink? If so how many glasses per week?
15. Do you feel drops in our energy level throughout the day? If so when?
16. How many glasses of water do you drink per day?
17. Do you drink fizzy drinks? If so how many bottles per week?
18. What percentage would you rate your healthy eating vs unhealthy eating? Eg. 60% healthy 40% unhealthy
19. Do you have a gym membership? If not would you be willing to start one?
20. How many times do you eat out per week? (Including fast food & restaurants)
21. Do you have ay existing medical condtions? If so what are they?
22. If you are currently on any medication(s) please list them.
23. Do you know how many calories you eat per day? If so how many do you think?
24. How much time do you have available to train per week? Days per week plus time per session.
25. On a scale of 1-10 how motivated are you to make a change? 1= not motivated, 10= highly motivated
26. Do you suffer with bloating?
27. Do any foods make you feel uncomfortable after consuming them?
28. Do you see investing in your health as important?
29. Please list any current or recent injuries and label them as current or previous.
30. What do you wish to accomplish from personal training?
31. What equipment do you have access to?
32. Do you track your steps and if so how many do you average each day?
Thanks for submitting!