Custom Program Questionnaire
Please note that due to the digital nature of the coaching services and training programs I cannot offer any refunds on products that have been purchased or services that have been rendered. Also note that this form CANNOT be changed after it is submitted. If you would like to make a change, you will have to submit an entire new form. Sorry, but that's because of Google (its a long story) lol
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Email (so I can contact you personally): *
Age: *
Sex: *
Height: *
Body weight: *
Approximate body fat % (if you know it):
Do you have any pre-existing injuries? If so, what injuries?
What sport/s are you training for? If you are not an athlete, what are your primary training goals (ie. gaining muscle, injury rehab, conditioning etc.)? *
If you are an athlete, what level/s do you compete in? *
Required
On average, how many hours of sleep do you get per night?
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What type of work you do? Is it physically intensive or sedentary? Is it highly stressful or relatively
low key?
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In terms of weight training, would you categorise yourself as novice, intermediate or advanced?
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How many days a week can you commit to training? If you train for a sport, how many days can you spend training for the sport AND how many days can you spend in the weight room? *
What training opportunities do you have during the week? Are there any days where you cannot workout at all? Can you fit in a small workout on some days? Please provide as much detail as possible.
How much time can you spend training in each session?
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What are your personal best lifts and when were they done?
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If you had to max out on all your lifts tomorrow, with solid form, what numbers would you be capable of hitting? Please list all the primary exercises that you have relatively accurate numbers for, e.g. low bar squat, high bar squat, front squat, bench press, overhead press, incline press, push press, conventional deadlift, sumo deadlift, trap bar deadlift, weighted chin-up, weighted dip, power clean, power snatch, etc. (this does not have to be a 1 rep max; it can also be 3rm, 5rm, 8rm, etc.)
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Please describe your usual style of weight training over the last few years (what you typically do in the gym) as well as how you have been training for the most part in the last few months (i.e. primary exercises, assistance exercises, exercise frequency, number of sets/reps, average intensity, etc. The more info the better).
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Are there any exercises/movements you cannot do (due to injury or other reason)?
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Are there any exercises or lifts you would specifically like for me to exclude from your program?
Do you have access to any specialty equipment or bars (e.g. glute-ham raise, reverse hyperextension, bumper plates, farmer's walk implements, safety squat bar, trap bar, yoke, prowler/sled, kettlebells, medicine balls, etc.)?
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If applicable, how much space is available for doing loaded carries and sled drags?
Do you have access to micro-plates (i.e. 1.25lbs or 0.5kg)?
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Do you have access to 1.25kg or 2.75lbs plates?
 *
If you have a home gym or are in a situation with limited equipment available, please list ALL equipment that currently you have access to.
Would you like me to write out your weight progressions in pounds or kilograms?
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Are there any notes you would like to add or special considerations you would like me to factor in to your training program?
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