Name
Sex
Date of Birth
Length
Weight
Fat% if not sure make an estimation based on the picture
Telephone number
Your email
How healthy are you in your own opinion on a scale of 1-10? (0 = very unhealthy and 10 = very healthy) 12345678910 Do you have physical symptoms? (Eg. injuries or complaints that come and go, such as neck and back pain) yesno If so, during which movements and / or situations do the symptoms flare up? Are there physical or pathological factors the trainer should keep in mind? (Operations, muscle diseases, bone abnormalities, etc.) Do you use drugs? (Not required, but valuable information) Do you have certain allergies that have to be taken into account? Be sure to note other issues , that you feel the trainer should take into account? Information about Lifestyle How active are you? Very Active (you exercise five times a week for one or more hours or a job in which you are physically active a large part of the day)Active (you exercise 2 to 3 times a week for more than an hour at a time)Lightly active (you exercise 1 or 2 times per week for an hour and you have a sedentary job)Very lightly active (you exercise 1 time per week and have a sedentary job)Not active (you exercise infrequently and have a sedentary job) Do you use supplements? (protein - shakes, multivitamins, " superfoods " , etc.) Do you smoke?yesno Are you being coached by a health and fitness professional at the moment?yesno Have you ever been coached/advised in terms of health and fitness?yesno
Goals and expectations in health What do you need help with? Nutrition, training, health and wellbeing, or something else? What are your goals? Short term, long term or it does not matter? What are your expectations with regards to the achievement of these goals? What days are you available for advice / training? And in what locations? Are you also available to have sessions on the phone of via video chat (skype or facetime)?
Budget What is your current budget for training and/or advice per month?
