PRE QUESTIONARE

1

Name

First Name

Last Name

2

Email

example@example.com

3

Phone Number

Area Code

Phone Number

4

Height?

5

Current weight?

6

Occupation?

7

Have you previously had a PT Session?

YESNO

8

Have you been exercising in the last 12 months?

YESNO

9

If NO why?

10

What are your main goals?

11

Why is this important to you?

12

When would you like to achieve this by?

13

Do you track calories / macros currently?

YESNO

14

If so what is your intake?

15

Please give a brief daily log (breakfast, lunch, dinner, snacks)

16

What is your water intake?

17

What is your daily stress levels like?

18

Do you smoke/ vape?

YESNO

19

Whats your daily step count?

20

Any injuries I should know about?

21

Medical History or any conditions?

22

Are you currently pregnant?

YESNO

23

Last period ?

24

Medications?

25

Favourite treat food?