Personal Training Questionnaire

Personal Training Questionnaire

An easy systematic questionnaire aimed at obtaining the most relevant details of a potential client to pre screen them before your initial consultation Form Preview
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Welcome to the team!
Welcome to the team!
Please take 10 minutes to fill out and submit this form.
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    Example: 182cm/75kg/15%
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  • 7
    If selected Yes, please elaborate in text box
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  • 9
    If selected Yes, please elaborate in text box
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  • 10
    If selected Yes, please elaborate in text box
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  • 11
    If selected Yes, please elaborate in text box
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  • 12
    If selected Yes, please elaborate in text box. This is not soft tissue and joint related 
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  • 13
    Please list date of the incident, any treatment/rehabilitation and if the condition still persists.
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  • 14
    Word of mouth
    Facebook
    Instagram
    Google search
    Other            
    Word of mouth
    Facebook
    Instagram
    Google search
    Other            
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  • 15
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  • 16
    Have you had a structured program with your workouts set out, rep schemes, rest, exercise order etc.
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  • 17
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  • 20
    Whats the most you have squat, bench and deadlifted and for how many reps. 
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    Example. I would like to get to 10% bodyfat and get stronger in my squat
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  • 24
    It is always good to set deadlines. 
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  • 25
    Created with Sketch.
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  • 26
    The lower the score would indicate you are suffering the most
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    Overall energy levels
    Overall stress
    Mood
    Anxiety
    Strength/fitness 
    Overall energy levels
    Overall stress
    Mood
    Anxiety
    Strength/fitness 
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    Examples. job commitments, sleep quality, diet, family commitments etc.
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  • 36
    These are foods that cause allergy like symptoms (bloating, cramps, nausea etc.)
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  • 37
    Tried it 
    Currently doing
    No, open to trying
    No interest in trying
    Dont know
    Meat 3 veg
    Paleo
    Vegetarian
    Vegan
    High Protein
    Macros
    Clean Eating 
    Fasting 
    Portion Control
    Meat 3 veg
    Paleo
    Vegetarian
    Vegan
    High Protein
    Macros
    Clean Eating 
    Fasting 
    Portion Control
    Tried it 
    Currently doing
    No, open to trying
    No interest in trying
    Dont know
    Tried it 
    Currently doing
    No, open to trying
    No interest in trying
    Dont know
    Tried it 
    Currently doing
    No, open to trying
    No interest in trying
    Dont know
    Tried it 
    Currently doing
    No, open to trying
    No interest in trying
    Dont know
    Tried it 
    Currently doing
    No, open to trying
    No interest in trying
    Dont know
    Tried it 
    Currently doing
    No, open to trying
    No interest in trying
    Dont know
    Tried it 
    Currently doing
    No, open to trying
    No interest in trying
    Dont know
    Tried it 
    Currently doing
    No, open to trying
    No interest in trying
    Dont know
    Tried it 
    Currently doing
    No, open to trying
    No interest in trying
    Dont know
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  • 38
    Please provide a description of a days food and fluid from Meal 1 to Meal "x"
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  • 39
    Yes
    No
    Drink Coffee Daily
    Use Pre-workout more than 1 x per week
    Drink alcohol more than once a week
    Smoke ciggarettes
    Drink 3L water per day
    Drink soft drink regularly
    Drink Coffee Daily
    Use Pre-workout more than 1 x per week
    Drink alcohol more than once a week
    Smoke ciggarettes
    Drink 3L water per day
    Drink soft drink regularly
    Yes
    No
    Yes
    No
    Yes
    No
    Yes
    No
    Yes
    No
    Yes
    No
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  • 40
    Yes
    No
    Joint Pain
    Digestive Issues
    Lethargy
    Bloating
    Bad Menstrual Periods           
    Joint Pain
    Digestive Issues
    Lethargy
    Bloating
    Bad Menstrual Periods           
    Yes
    No
    Yes
    No
    Yes
    No
    Yes
    No
    Yes
    No
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  • 41
    Confident
    Somewhat Confident
    Not Confident
    Im prepared to track my food intake
    Im prepared to fill in my training plan
    Im prepared to send progress pictures as specified
    Im prepared to fill in my tracking sheet 
    Im prepared to modify my diet
    Im prepared to take supplements as necessary
    Im prepared to modify my lifestyle habits 
    Im prepared to track my food intake
    Im prepared to fill in my training plan
    Im prepared to send progress pictures as specified
    Im prepared to fill in my tracking sheet 
    Im prepared to modify my diet
    Im prepared to take supplements as necessary
    Im prepared to modify my lifestyle habits 
    Confident
    Somewhat Confident
    Not Confident
    Confident
    Somewhat Confident
    Not Confident
    Confident
    Somewhat Confident
    Not Confident
    Confident
    Somewhat Confident
    Not Confident
    Confident
    Somewhat Confident
    Not Confident
    Confident
    Somewhat Confident
    Not Confident
    Confident
    Somewhat Confident
    Not Confident
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  • 42
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  • 43
    By signing this document you are stating you have read all the questions and content and have answered truthfully
    Clear
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