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Discovery Form
WELCOME ! Please take the time to fill out this form. The more info we have about you, the more we can help you.
Email *
Date *
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Full Name: *
Postcode *
Phone number *
DOB *
Gender
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TRAINING
Tell us a little bit about, what you have done before
So what has brought you here, and what outcome you are looking for.
Are you currently doing any type of Fitness / Training?
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If YES please give details, and whether you got the results you wanted.
What is your preference for training? *
What have you tried in the past?
Did you achieve your health and fitness goals?
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If NO what do you think the main reason was you didn't succeed?
NUTRITION
Please provide us with as much information as possible
Do you consider yourself to have a healthy diet?
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If NO, what is your biggest downfall?
Do you have any dietary requirements? i.e. vegetarian, vegan, gluten free etc?
Are you currently or have you ever tracked your food intake? If so how?
Do you struggle with any of the following? *
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Have you had help with your nutrition in the past? (ie Nutritionist, dietician etc)
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If YES, please provide details - Was it useful?
INJURIES
It is important that we have a history of your past injuries / pain in order to help you.
Do you have any current or past injuries that may affect your training? *
If YES, please provide details
Are you currently suffering from an ongoing pain? (ie Back pain, shoulder pain, knee pain? etc)
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If YES, Please provide us with details
Have you ever had a Coach or Personal Trainer alleviate your pain through exercise intervention?
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LIFESTYLE:
Please tell us a bit about your lifestyle...
Are you a smoker?
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On average, how many hours sleep do you get?
Do you have any significant stress in your life? (ie Work, family etc)
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If YES, please provide us with some details
MEDICAL
Do you have any health related issues
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If YES, please provide full details
Are you on any prescribed medications?
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If YES please provide full details including any side-effects you may have,
Are there any other issues that we need to know about?
Thank you for taking the time to complete this form, we will be in contact with you very soon to discuss how we can help you.
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