Amplified Strength And Conditioning Questionnaire
Thank you for taking the time to fill out this form, looking forward to seeing you in our session.
Name *
Your answer
Email *
Your answer
Address *
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Phone Number
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Occupation
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Birthday
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YYYY
Emergency contact name and number
Your answer
Best availability for training sessions e.g. Monday 4pm
Your answer
What are 3 current goals you wish to achieve? Most important listed first.
Your answer
Have you attempted to reach these goals previously?
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Did you achieve them? If yes, why did you revert? If no, why not?
Your answer
What will be different this time around?
Your answer
What are you prepared to do differently?
Your answer
What do you feel worked previously and what didn't work? Why?
Your answer
What is your reason for setting these goals? Your reason why.
Your answer
How will you feel if you don't reach your goals?
Your answer
How will you feel if you do reach your goal?
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What is your plan once you reach these goals? 
Your answer
What is your training history eg. How long have you been training consistently and current exercise program.
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If currently using a program, what results have you seen so far?
Your answer
Who (If anyone) designed the training program?
Your answer
What is your preferred style of training?
Your answer
How would you rate your current nutrition? (1 being the lowest and 10 being the highest)
Describe a normal day of eating for you (Be as specific as possible)
Your answer
What results have you seen following this nutrition?
Your answer
Who (if anyone) designed your current nutrition plan?
Your answer
How would you describe your day to day stress levels?
Your answer
How would you describe your quality/quantity of sleep per night
Your answer
Have you previously used a trainer or coach?
If yes, describe your experience with that trainer/coach (positives and negatives)
Your answer
Do you do much incidental exercise during your day? (i.e. Walking the dog, work related, walking to work etc.)
Your answer
Are you involved in any sporting activities?
Your answer
Do you have any medical conditions that may prevent you from exercising? If yes, in depth explanation please.
Your answer
Do you take any prescription medication, pills, tablets/supplements or have any known allergies or smoke? If yes, in depth explanation please.
Your answer
Risk - I acknowledge that it is a condition of participating in this activity that I do so at my own risk. I accept all risks and hereby indemnify and release the trainer against all liability. I acknowledge that participating in this activity may involve a risk of minor and major injury. I recognize the difficulties associated with the activity and attest I am physically fit to safely participate in the activity and that a qualified medical practitioner has not advised me otherwise. I understand the demanding physical nature of this activity. I am not aware of any medical condition, injury or impairment that will be detrimental to my health if I participate in this activity. In the event that I become aware of any medical condition, injury or impairment that may be detrimental to my health, my Trainer will be immediately informed. By continuing to participate in this activity, I accept the risks despite these conditions and am still, and will always be under the terms of this agreement.
Sessions and cancellations - All cancellations/session rescheduling must be received at least 24 hours before your training session in order to avoid being charged for your session. All sessions will be rescheduled within a 7 day period. Clients who do not cancel with less than 24 hours notice will be charged for the cancelled session. I provide every client with one free short -notice cancellation . You will not be charged for your first cancellation with less than 24 hours notice. Subsequent short-notice cancellations will be charged for the session. Of course emergencies do happen. In the case of an emergency cancellation, we will reschedule the session at an alternative time. If you arrive late - Sessions with my clients run back to back. Should you run late, unfortunately the session must finish on time. *
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