Initial Consultation
This helps us find out more about your goals or what you'd like to achieve...
Email address *
Personal Details
Name *
Your answer
Full Address *
Your answer
Contact Number *
Your answer
Date Of Birth *
MM
/
DD
/
YYYY
Lifestyle
How much sleep do you get each night? *
Your answer
Occupation *
Your answer
Describe your activity level during work? *
Does your job require a lot of travel? *
How many hours do you spending sitting? *
Your answer
Rate your stress levels generally? Enter 1 = Low stress / 10 = High Stress *
Low Stress
High Stress
3 biggest sources of stress i.e. Work, Lifestyle or Lack of sleep *
Your answer
What would you rate your current body shape? Enter 1=Not Ideal / 10 = Ideal? *
Not Ideal
Ideal
What would you like your body to be? Enter 1= Not Ideal / 10 = Ideal *
Not Ideal
Ideal
Fitness
When were you at your fittest? *
Your answer
When were you last exercising regularly? *
Your answer
What stopped you from getting fit in the past? *
Your answer
Where would you rate your current fitness level? Enter 1 = Low Fitness / 10 = High Fitness* *
Low Fitness
High Fitness
Where would you like your fitness to be? *
Low Fitness
High Fitness
Nutrition
Do you always eat breakfast? *
Do you ever skip meals? *
If Yes, Do you feel normal or dizzy? *
Do you eat late at night? *
How many glasses of water do you drink each day? *
Your answer
Do your energy levels drop during the day? *
Can you estimate how many calories you're taking in currently? *
Your answer
How many times a week do you eat out? *
Your answer
Do you have any allergies to foods? *
Such as gluten, or any symptoms of bloating or lethargy
Your answer
Personal Training
Have you had personal training before? *
If Yes, What were you training for? What exercises were you doing with your previous trainer? Did you get results?
Your answer
List 3 goals you'd like to achieve with your trainers help? *
Your answer
When would you like to achieve these goals? *
what's happening at this time? wedding, event, holiday
Your answer
How motivated are you to achieving these goals? Enter 1=Not Very / 10=Very *
Low motivation
High motivation
Additional Notes
Your answer
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