Andy Van Strength and Conditioning
Online Personal Training Questionnaire:
First and Last Name: *
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Email address: *
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Height (inches): *
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Weight (lbs): *
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Age (years): *
Your answer
What is Your #1 Goal? What do you want most of your training program (lose fat, gain lean muscle, etc.)? *
Your answer
On a Scale of 1-10, how serious are you about making a change? *
Meh
All In
What is you #2 Goal? After you achieve #1, what would you like to gain from this program? *
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What obstacles currently stand in your way to achieving your goals? *
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What is your occupation? What do you do for a living? *
Your answer
Do you have any previous injuries or health issues I need to know about? (ex: asthma, heart condition, back injury, shoulder injury, etc.) *
Your answer
List any medications you're currently taking: *
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How many workouts/week can you commit to? *
If provided calories and macronutrient guidelines, are you willing to track your nutrition EVERY DAY? *
Tell me more about your training history: How long have you been training? What worked, and what didn't work for you in the past? *
Your answer
How comfortable are you with exercises like the squat, deadlift, bench press, and chin-ups? *
Unfamiliar/unsure
Expert: I know them all
What equipment do you have readily available to you? *
Required
If there is anything we haven't covered, or if you'd like to voice any questions or concerns, please fill out below. If not, type "none" so I know that you've completed every response on this form.
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