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New/Potential Client - Info Form
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Email
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Your email
Full Name
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Your answer
Instagram handle
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Your answer
Age
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Your answer
Height (cms)
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Your answer
Weight (kg)
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Your answer
What Country/Time Zone are you on?
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Your answer
Mobile number (WhatsApp)
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Your answer
What date can you start the program? Can you commit to a minimum sign up of 12 weeks of coaching?
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Your answer
How many calories are you consuming on a daily basis?
Your answer
How much protein are you consuming on a daily basis?
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Your answer
Have you any specific dietary requirements/intolerances?
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Your answer
Describe your gut health (detail frequency of bowel movement & consistency)
Your answer
Do you have a healthy relationship with food?
Your answer
Have you ever tried any fad diets? (KETO, Atkins Diet, Intermittent Fasting)
Your answer
What is your occupation?
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Your answer
Do you do shift work? If yes please outline.
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Your answer
What's your training background/history?
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Your answer
How many times per week are you active?
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Your answer
What package are you signing up for?
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1:1 Online Coaching
Hybrid Coaching (Face to Face + Online Coaching)
1:1 In Person Coaching
What is your weekly budget that you can spend on your health/fitness
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Your answer
Are you taking any supplements? (if so what ones e.g Vit D, Creatine, Protein Powder)
Your answer
What are your health/fitness goals, when do you want to achieve these by?
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Your answer
What has held you back from reaching your goals in the past?
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Your answer
When was the last time you were training consistently for at least 6 months (if ever) ?
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Your answer
How many days can you commit to training?
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1
2
3
4
5
Whatever you suggest
What days/times suit you for in person coaching? (if that's the package your signing up to)
Your answer
How many steps are you getting per day?
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Your answer
Do you own a smart watch? If yes what brand?
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Your answer
Do you have any medical conditions I should be made aware of?
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Your answer
Are you taking medication? Please advise.
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Your answer
Do you drink alcohol? If so how many units of alcohol per week?
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Your answer
Do you have any pre-existing injuries? Are you physically compromised in any way?
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Your answer
What are your current stress levels like and sleep hygiene like?
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Your answer
Which describes you
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Not on contraceptive/Tracking my menstrual cycle
Taking contraception
Pre Natal
Post Natal
Peri Menopausal
Menopause
Post Menopause
N/A
Other:
Do you have gym membership/ access to weights / home gym? Would you like a gym/home based program or both?
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Your answer
How confident are you in the gym ?
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Your answer
Are you familiar with gym machines/equipment?
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Your answer
Are you doing any cardio, how are your fitness levels?
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Your answer
Why do you want to work with me?
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Your answer
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