New Client Questionnaire
Jin Training Systems, LLC
Name
First Name
Last Name
Email
example@example.com
Phone Number
-
Area Code
Phone Number
Do you have an Instagram for the purposes of a training log? (If so, link me the account)
Age
Height
Average bodyweight (Morning in underwear)
Gender
Male
Female
Other
Prefer not to say
How many years of general Weightlifting and/or Sports experience do you have? (Specify your experience)
How many days do you workout per week? (Realistically speaking)
Have you ever tracked your calories and/or Macronutrients?
Yes (currently tracking)
Yes (in the past)
Yes (but only calories)
No
How many years of Powerlifting specific experience do you have?
0-6 months of training (Novice)
6-12 months of training (Intermediate)
1-2 years of training (Late-Intermediate)
2-3 years of training (Advanced)
3+ years of training (Veteran)
What is your 1 rep max on Squat? (If unknown, list the heaviest weight and number of reps you have done)
What is your main Squat stance?
High Bar (Olympic weightlifting style, Barbell is set on the traps)
Mid Bar (Hybrid Barbell placement in between traps and rear deltoids)
Low Bar (Powerlifting style, Barbell is set on rear deltoids)
I am unsure
What is your 1 rep max on the Bench Press? (If unknown, list the heaviest weight and number of reps you have done)
What is your atypical grip width on the Bench Press?
Close Grip (Pinkies do not go past the outside of the rings on a Power Bar)
Medium Grip (Middle finger is covering the rings on a Power Bar)
Wide Grip (Index finger is just covering the rings on the outside of a Power Bar)
I am unsure
What is your 1 rep max on the Deadlift? (If unknown, list the heaviest weight and number of reps you have done)
What is your main Deadlift Stance?
Shoulder Width Conventional (Classic)
Snatch Grip Conventional (Weightlifting style)
Hybrid Sumo (Ex: Ed Coan)
Wide Sumo (Ankles align with or are wider than the rings on a Power Bar)
What are some past training programs you have done?
Have you ever received Personal Training or Coaching before? If so, what made you decide to discontinue?
How did you hear about us?
Facebook
Instagram
Friend Referral
Other
What are your short-term (1-3 months) and long-term (1+ year) goals?
What type of Coaching Service are you looking to purchase?
Program+Coaching+Nutrition
Video Consultation Only
Meet Day Coaching Only
Technique Analysis Only
Submit
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