Welcome to your consultation questionnaire! Your responses are going to allow me to give you as comprehensive a service as possible, so answer in as much detail as you can.
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Date of Birth
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Current Bodyweight in kg or lbs (please specify)
Height in cm/m or feet (please specify)
Has your doctor ever said you have a heart condition and that you should only do physical activity as recommended by a doctor?
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Do you feel pain in your chest when you do physical activity?
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Do you feel pain in your chest when you do physical activity?
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In the past month, have you had a chest pain when you were not doing physical activity?
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Do you lose balance because of dizziness or do you ever lose consciousness?
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Do you have a bone or joint problem (for example, back, knee or hip) that could be made worse by a change in your physical activity?
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Is your doctor currently prescribing medication for your blood pressure or heart condition?
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Do you know of any other reason why you should not do physical activity?
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If you answered yes to any of the above, have you consulted with your doctor to clarify it's safe for you to become physically active and in your current state of health?If you answered no to all the previous questions, by selecting "yes" you confirm that it is safe for you to participate in physical activity.
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What are your goals? Please write in as much detail as possible, giving time frames if applicable.
Do you have any health issues that affect your diet? If so have you ever been told by a health professional to avoid certain foods?
On average, how much sleep do you get per night? Do you feel rested upon waking?
Do you currently follow any approach to your diet? If yes please outline below. If no please give a typical day's worth of food below.
What are your favourite foods and drinks? These can be "healthy" or "unhealthy"... there's no right or wrong here!!
What foods or drinks do you dislike?
Do you currently follow a training program? If so please outline in as much detail as possible. If you have it as a document you can forward it to
What do you do for your work/job and what are your working hours like?
How many times per week can you realistically train?
Do you have any niggles or injuries you have to work to stay on top of?
What kit does your gym have available/what kit do you have access to at home? Be as detailed as you can, especially with kit/machines you like to use.
Pictures can act as a great motivator and metric for progress away from simply just scale weight. If you're happy doing so, take a photo from approximately navel height from the front, back and side in as little clothing as you're comfortable with.
Do you have any questions for me, or anything you think I've missed that should be considered in the design of your training and nutrition plan?
Thank you for taking the time to complete the consultation form. Your resources will land themselves in your inbox shortly, so keep your eyes peeled!
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