Which type of coaching are you interested in?

In-Person Personal Training/Coaching

Online Personal Training/Coaching

PAR-Q FORM please mark yes or no to the following 7 questions

1. Has your doctor ever said that you have a heart condition and recommended only medically supervised physical activity?

Yes

2. Do you frequently have pains in your chest when you perform physical activity?

Yes

3. Have you had chest pain when you were not doing physical activity?

Yes

4. Do you lose your balance due to dizziness or do you ever lose consciousness?

Yes

5. Do you have a bone, joint or any other health problem that causes you pain or limitations that must be addressed when developing an exercise program? i.e. diabetes, osteoporosis, high blood pressure, high cholesterol, arthritis, respiratory ailments, back problems, etc.?

Yes

6. Do you take any medications, either prescription or non-prescription, on a regular basis?

Yes

HEALTH AND LIFESTYLE INFORMATION: 10 important questions

5. List your 3 biggest sources of stress?

CURRENT FITNESS AND FITNESS HISTORY: 8 important questions

2. What previous fat loss, lean muscle gain, or body improvement treatment(s) have you tried? Please state what and when.

3. Have you ever worked with a personal trainer? If so, what did you like and what could have been better?

4. Do you have any past medical history that may impact your ability to exercise? If so, please explain:

5. Describe your injury history. Be as specific as possible

6. Are there any areas of your body that you consider “problem areas”?

7. Have you been exercising consistently for the past 3 months?

Yes

1. How often do you take part in physical exercise?

1-2 x per week

3-4 x per week

5-7 x per week

2. If your participation is lower than you would like it to be, what are the reasons?

Lack of interest

Lack of time

Illness/Injury

Other

3. How many days per week do you want to spend working out?

7. Please mark how you prefer to exercise. You can select more than one

8. What are the best days during the week for you to commit to your exercise program? [select multiple]

3. What activities do you engage in while eating? [TV, reading, social media etc.]

4. Do you feel drops in your energy levels throughout the day?

Yes

5. Please list any supplements you are currently taking / have taken in the past?

8. Is there any area of your nutrition/ food that you would like to improve? Please explain

10. How often do you consume drinks containing sugar [i.e coffee, coke, fizzy drinks, diet coke, fruit juices]

11. How often do you experience abdominal bloating?

12. Do you frequently have loose stools or diarrhea?

13. How often do you experience constipation?

14. How often do you have indigestion, heartburn or an upset stomach?

15. How would you describe your relationship with food? [Do you worry about calories, are you always dieting, do you ever feel guilty for what you eat, etc.]

2. What do you want to achieve? It can be related to physical fitness, your body, health, eating habits etc.

3. From the above, please list in order of priority, the goals you want to achieve

4. Why is your goal so important? How will it make you feel / what impact will it have on your life? Be specific

5. What obstacles stand in your way? i.e not training consistently, upcoming holiday, busy season at work, overwhelming feeling, all-nothing mentality, not following the program, allowing other responsibilities to become a priority over exercise etc.).

6. Where do you rate health in your life?

Never / Rarely

Medium Priority

High Priority

Thank you for filling out your questionnaire. Your posture and movement assessment is coming up. Check your email shortly

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INITIAL QUESTIONNAIRE

CONTACT DETAILS

PAR-Q FORM please mark yes or no to the following 7 questions

HEALTH AND LIFESTYLE INFORMATION: 10 important questions

CURRENT FITNESS AND FITNESS HISTORY: 8 important questions

EXERCISE HABITS AND PREFERENCES: 8 important questions

NUTRITION AND DIGESTION: 15 important questions

GOALS: 7 important questions

Thank you for filling out your questionnaire. Your posture and movement assessment is coming up. Check your email shortly