INITIAL QUESTIONNAIRE

CONTACT DETAILS

Which type of coaching are you interested in?

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?
2. Do you frequently have pains in your chest when you perform physical activity?
3. Have you had chest pain when you were not doing physical activity?
4. Do you lose your balance due to dizziness or do you ever lose consciousness?
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.?
6. Do you take any medications, either prescription or non-prescription, on a regular basis?
7. Do you smoke?

HEALTH AND LIFESTYLE INFORMATION: 10 important questions

1. Do you drink alcohol?
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3. Do you find it hard to fall / stay asleep?
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8. Do you suffer from back pain?
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CURRENT FITNESS AND FITNESS HISTORY: 8 important questions

7. Have you been exercising consistently for the past 3 months?
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EXERCISE HABITS AND PREFERENCES: 8 important questions

1. How often do you take part in physical exercise?
2. If your participation is lower than you would like it to be, what are the reasons?
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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]

NUTRITION AND DIGESTION: 15 important questions

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

GOALS: 7 important questions

1. How can Generation Strength help you? What are your goals? You can select multiple
6. Where do you rate health in your life?
Thank you for filling out your questionnaire. Your posture and movement assessment is coming up. Check your email shortly
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