Date of Birth
What goals do you want to achieve?
Are you currently working?
If you are currently working, how many hours do you work per week?
How would you describe your daily activity?
SedentaryLight activityModerate activityHeavy activity
How many hours of sleep do you have each night?
Less than 5 hours5-6 hours6-7 hours7-8 hoursMore than 8 hours
How would you describe the quality of your sleep?
Do you have any injuries or medical conditions we should be aware of?
If any, what diets have you followed in the past?
Have you had any success with those diets?
Tell me about your current diet.
Do you currently have any accountability strategies in place?
If you drink alcohol, how many standard drinks do you consume per week?
Have you had a personal trainer or coach before?
Could you describe what that experience was like?
How would you describe your current exercise or training regime?
Have you participated in strength training in the past?
Add any other relevant notes below.
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