Questionnaire | Personal Trainer | Plymouth | The Lemon Frog Fitness Company

CONSULTATION 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. How many times do you go food shopping per week?

9. Would you say you have high levels or low levels of stress in your life?

10. Describe your current sleep routine. What time do you go bed, do you fall asleep easily or struggle, how many hours do you get, do you wake up feeling tired?

11. Is your job sedentary, active or physically demanding?

12. Do you have any children?

13. Do you smoke? If so how many times per day?

14. Do you drink alcohol? If so how many units/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. Would you be able to provide a food diary up to three days before our consultation?

32. Do you track your steps and if so how many do you average each day?