On Boarding Questionnaire
Introduction

Please answer all questions as honestly as possible, there is no judgement, no wrong answers and everything will be confidential. The more information that you provide, the more detail I and your coaches will be able to provide when writing your plan and advising in check ins. 

Where there is a rating from 1-5 (1 being the worst or lowest and 5 is the best or highest).

Please give as much detail as possible.

Thanks
Simon

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Email *
Full Name *
PAR - Q
Please answer the following questions, as they are legal requirements.
Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor? *
Do you feel pain in your chest when you do physical activity?
 *
In the past month, have you had chest pain when you were not doing physical activity?
 *
Do you lose your balance because of dizziness or do you ever lose consciousness?
 *
Do you have a bone or joint problem that could be made worse by a change in your physical activity?
 *
Is your doctor currently prescribing drugs?
 *
Do you know of any other reason why you should not do physical activity?
 *
If you answered "Yes" to any of the above questions, please elabrate below
Personal Details
Please fill out details
Date of Birth *
Current Weight (KG) *
Height (cm) *
Contact Number *
Address *
ENERGY EXPENDITURE
Occupation (please specify)
How active is your job (rate 1 – 5)
Sedentary
Very Active
Clear selection
How many hours are you currently training/exercise a week?
Do you do any other form of leisurely activity?
GOALS
What is the main goal that you would like to achieve out of this coaching process? *
Required
Do you have anything specific we need to consider in these training goals
SLEEP
How much sleep do you get per night on average (hrs)
How would you rate your sleep quality (rate 1 – 5)
Poor
Excellent
Clear selection
What time do you go to bed usually
Time
:
What time do you wake up usually
Time
:
Do you normally wake up in the night
Clear selection
ENERGY LEVELS
How are your energy levels throughout the day (rate 1 – 5)
Upon Waking
Low
High
Clear selection
3 hours after waking
Low
High
Clear selection
6 hours after waking
Low
High
Clear selection
9 hours after waking
Low
High
Clear selection
12 hours after waking
Low
High
Clear selection
HYDRATION, CAFFEINE, ALCOHOL
How much fluid do you drink a day on average (L)
Clear selection
How much coffee, tea, caffeinated energy drinks & fizzy drinks do you drink per day (please specify which and how much)
Do you drink alcohol and if so how much do you consume (also please specify what type you tend to drink)
NUTRITION
Where do you get your information regarding nutrition from (i.e. journals, books, social media, blogs)
Do you have a good understanding of the macronutrients
Clear selection
Do you have an understanding and have you tried flexible dieting or IIFYM in the past (if so how did you get on and how did you find it)
Are you able to be creative, follow a recipe book or video to make tasty meals
Clear selection
Do you have access to recipe books or videos
Clear selection
In the past 2 years have you tried any other diets (if so please specify and any long-lasting results)
Do you have any dietary requirements (i.e. vegan, vegetarian or any religious reasons)
Do you know how to weigh and measure food using scales
Clear selection
Do you have good knowledge of tracking your food intake via the app MyFitnessPal
Clear selection
Do you have any food preparation time in the evenings or weekends
Clear selection
Does your place of work have cooking, reheating or fridge facilities
Clear selection
In your own opinion what do you think you could improve on most regarding your nutrition?
How many meals do you like to eat per day
How often do your graze/snack per day
SUPPLEMENTS
Do you take any supplements (if so please specify; what, why and where you get them from)
TRACKING
Do you have the following fitness tracking devices (yes/no)
Digital food scales, which measure in grams
Clear selection
Digital body weight scales, which weigh measure in kilograms
Clear selection
A smartphone
Clear selection
A heart rate monitor
Clear selection
Pedometer
Clear selection
Fit Bit, Apple I-watch or similar
Clear selection
EXTRAS
Do you have any planned holidays (please specify dates if known)
If you were unable to attend the gym, what is your ability to train at home like?
Are there any exercises that you can not perform due to injury/restriction that you know of? *
Is there anything that you would like to add at this point to give me a clearer understanding of how I can help you
We love sharing results of our members. We don't show faces or personal details but if you don't want anything shared of your results, please let us know
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