Health and Fitness
This questionnaire will give me important information in order to understand your needs and goals. This will help me give you the best service in your first consultation and subsequent intro sessions.

Please answer honestly and take your time. If there is any question you don't feel comfortable asking, please skip it.

How would you describe your health?
On a scale of 1 (poor) to 5 (excellent) how would you rate your current eating habits?
Have you ever had a personal trainer?
If yes, how was your experience?
Your answer
Do you suffer from any stress related symptoms? (You can choose more than one.)
Are you sedentary (do not exercise at all)?
Do you spend hours seated?
Please rate the following from 1 (poor) to 5 (excellent)
1
2
3
4
5
Strength
Endurance
Coordination
Agility
Balance
Flexibility
What are your current health goals? (You can choose more than one)
Do you feel you have any obstacles (actions, beliefs, behaviours) that may impede your progress towards achieving your goals?
Name
Your answer
Date of birth
MM
/
DD
/
YYYY
Email address
Your answer
Mobile (optional)
Your answer
Gender
What is your profession?
Your answer
Thank you for your time. I will contact you within 24 hours. Is there anything else you would like to tell me?
Your answer
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