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New Client Form
This form is for the 1:1 Training option.
If you don't know what the service is, please contact me on any of my social media accounts.
Please fill out the form to the best of your ability, so I can help you as much as I can.
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Email
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Your email
What is your weight? (in Kg)
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Your answer
What is your height? (in cm)
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Your answer
How old are you? (in years)
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Your answer
If you count your steps (you can check the health app on your phone), how many steps do you hit per day (on average)?
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Your answer
What is your body fat % (if known)? If no known, just write N/A
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Your answer
Have you ever tried losing/ gaining weight before?
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Yes
No
Required
What method of weight gain/ loss did the diet involve? Tracking calories? Improved nutritional habits? Food restriction? What did you do to change your weight or keep it the same?
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Your answer
Can you describe how that went?
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Your answer
On a scale of 1 to 10, 10 being perfectly adherent, can you rate your overall adherence to that "diet"?
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On a scale of 1 to 10, 10 being the perfect mood state, can you rate your overall mood during the day when you were on the "diet"?
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Do you know how many calories you currently take in on average?
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Yes
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How many calories do you eat per day (If applicable)?
Your answer
Do you have a weight scale?
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Yes
No
Required
Other than sending weight updates, which of these methods of progress tracking are you comfortable with (you can check more than one option)?
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Waist circumference
Progress pictures
Neither
Required
Do you have a food scale?
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Yes
No
Required
Are you willing to track the food you eat? (Keep in mind that it could be a really accurate way of getting results)
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Yes
No
If you have ever worked out before, can you describe what your goals were when performing the workout?
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Your answer
Can you describe how you felt when you worked out?
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Your answer
On a scale of 1 to 10, 10 being super energized and not tired at all, how did you feel, in terms of energy, throughout the day after your workout?
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How many steps do you hit per day (if you track them)?
Your answer
What kind of exercise equipment do you have access to?
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Your answer
Describe your training goals for me. Are you focusing on building your physique (bodybuilding style training), or your main lifts (bench/squat/deadlift) for more powerlifting style training?
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Your answer
What do you expect out of this service? How can I best help you? Why did you choose to do this? Be as specific as possible.
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Your answer
A copy of your responses will be emailed to the address you provided.
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