Strive S&C Personal Training Questionnaire
This form gives us understanding of what your personal training needs and on all things that affect your health and well-being. It helps us to begin to make recommendations on which personal trainers to have reach out to you for you to choose from to successfully accomplish your goals.  
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Full Name *
Email *
Phone *
How did you hear about us? 
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Age
What is your biological sex?
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How tall are you?
How much do you weigh right now?
In general, what are your goals? Check all that apply *
Required
What do you expect from the coach who will be training you? *
Have you tried anything in the past to change your habits, your health, your eating, and/or your body? *
If so, what?
Which of those things worked well for you? (Even if you might not be doing it right now.)
Which of those things didn't work well for you?
Until now, what (if anything) has blocked you or held you back from achieving your goals?
Right now, how would you rank your overall eating/nutritional habits? *
Horrible
Awesome!!!
Are you regularly active in sports and/or exercise? *
If so, approximately how many hours per week?
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Approximately how many hours a week do you do other types of physical activity? (e.g. housework, walking to work or school, home repairs, moving around at work, gardening)
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Right now, how much do the people and things around you support health, fitness, and/or behavior change?
NOT AT ALL
COMPLETELY
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Have you been diagnosed (currently or in the past) with any significant medical condition(s) and/or injuries? *
Right now, do you have any specific health concerns, such as illnesses, pain, and/or injuries? *
Right now, are you taking any medications, either over-the-counter or prescription? *
On a scale of 1-10, how would you rank your health right now? *
WORST
AWESOME!!!
On a scale of 1-10, how do you feel about your schedule, time use, and overall busy-ness? *
MY LIFE IS PANICKED AND INSANE
MY LIFE IS PERFECTLY CALM AND RELAXED
Given all the demands of your life, what is your typical stress level on an average day? *
NO STRESS
EXTREME STRESS
On average, how many hours per night do you sleep? *
Which days would you ideally meet for training?  *
Required
What time of day would you ideally train? *
Required
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