BodySculptor Online Training
Please answer all the questions as accurately as possible, this will help us create a plan effective specifically for you.
Email address *
Your Name *
Date Of Birth *
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Mobile Phone Number *
Gender *
Your Body Goal *
Your Height *
Your Weight *
Are you taking any medication or drugs? If so, please list medication, dose and reason
Does your Physician know you are participating in the exercise program? *
Describe any physical activity you do somewhat regularly? *
Diet Preference *
Supplement History (Dosage & brands) if any
Any diets followed in the past?
Any Hunger Pangs?
Do you get any food cravings or mood effects from food, if so please explain briefly
What's your water consumption like on a typical day?
What is your Oil Consumption like?
Do you drink alcohol? *
Do you smoke? *
Any Food Allergies? *
Any main meals skipped? If so please explain briefly
Any signs or symptons from the following, check all that apply if any
Current Medications (If any)
Foods liked
Foods disliked
Do you now, or have you had any of the following in the past? (Tick only those that apply)
Any final comments for us, please leave here
Thank you for filling in this information, we will be in touch within 3 working days with your customised plan.
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