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Client Questionnaire
To help me have a better understanding of what you are looking to get out of training, please fill out this initial client questionnaire. Be as detailed as you can and please be as honest as possible, I can smell bullshit a mile away.
Email *
Name *
Age *
Height (cm) *
Weight (kg) *
Contact number *
How did you hear about Louis Doctrove Personal Training? *
Are you interested in Personal training or Online training? *
What is your ultimate goal with training and why? (try to be as detailed as possible) *
What is your timeline for achieving this goal ? *
What is your motivational level to reach this goal? (1 lowest - 10 highest) *
Are you currently doing any form of training? if so, how many times per week ? *
Have you worked with a personal trainer before? If so how was the experience ? *
Have you ever followed a resistance or weight-based training program? *
Have you ever tracked your daily steps? if so how many are you averaging a day? *
Do you look in the mirror and feel disappointed by the way you look? *
Which part/parts of the body do you wish you could improve? *
What days and times would you prefer to train ? *
Are you prepared to completely change the food that's in your kitchen in order to get a result ? *
Are you prepared to make food either the night before or first thing in the morning so that you’re prepared everyday? *
Are you prepared to eat between 3-5 meals per day? *
Are you prepared to train a minimum of 3-4x per week to reach your goal? *
Are you prepared to get between 7-8 hours restful sleep per night? *
Outline what you feel are the obstacles, behaviors or activities that could impede your progress towards accomplishing your goals (not training consistently, social life, upcoming trip, busy season at work) *
Have you ever had? *
Yes
No
a heart attack
cardiac surgery
extreme chest discomfort
high blood pressure (over 140/90)
heart murmurs
ankle swelling
any vascular disease
unusual shortness of breath
fainting spells
asthma, emphysema, or bronchitis
Are you currently on any medication? If so what ? *
Any previous injuries or pains I should know about ? *
Where do you rate the importance of health in your life? *
Required
Do you smoke? If so, how many per day/week? *
What do you do for a living ? *
How stressful would you say your job is - scale 1-10 (1 lowest - 10 highest) *
Do you work on weekends ? *
What’s the activity level at your job? *
What time do you start work ? *
What time do you usually finish work? *
What time do you usually go to sleep? *
What time do you wake up? *
Are you in a deep sleep throughout the night or are you constantly waking up? *
Do you go to sleep feeling hungry or full? *
How would you describe your current diet? *
How many meals do you eat in a day ? *
Do you skip breakfast in the mornings? *
Do you consume alcohol? If so, how many drinks per day/week? *
How much water are you drinking in a day? *
What are your eating habits like on the weekends? Is it a free for all or are you conscious of what you're consuming? *
Do you snack between meals ? if yes what are you snacking on? *
Do you suffer from bloating when you eat a meal ? *
Do you suffer from gas ? *
Do you suffer from constipation? *
Do you feel fatigued after eating a meal ? *
Are there any foods that cause you severe discomfort when you eat them? If so which foods? *
Have you ever attempted to track your calories? *
Have you ever attempted to track your macros? *
Did you find tracking your food intake successful ? *
In the last 6 months have you found your weight staying the same, going up or going down? *
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