Please list your height (in cm's), weight (kg's) and body fat percentage (if known)
Has a doctor stated you have high blood pressure?
Have you suffered from either heart disease, stroke, sudden death, elevated cholesterol?
Are you currently on prescribed medication? Does it effect your training?
Do you have or have you suffered from diabetes?
Have you had any blood tests conducted in the past 6 months?Was there anything to be concerned about?
Are you currently seeing any medical specialists atm? Please elaborate.
Are you pregnant or have given birth in the past 6 months?
Is there anything that hasn’t been mentioned that could potential affect your health and well being in relation to your training program?
Please list any muscular or joint injuries, aches, limitations or pains.
How long have you been training for?
Have you followed an exercise program before?
What are your strongest lifts in those movements?
How many times per week will you commit to your training program?
How many hours of sleep on average do you get per night
What are the main contributors to your overall stress?
What is your occupation? What are the demands of your role physically and mentally?
How much time and what activities do you do to relax?
Please rate on the scale truthfully (1=Poor to 10=Excellent)
Overall energy levels
Select the preferences that apply
No, open to trying
No interest in trying
Meat 3 veg
Drink Coffee Daily
Use Pre-workout more than 1 x per week
Drink alcohol more than once a week
Drink 3L water per day
Drink soft drink regularly
Do you suffer from:
Bad Menstrual Periods
List your goals and give a brief description of what they mean to you
When would you like to achieve your results by?
Please answer the following truthfully
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
Signature provided by Client
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