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Important: Please Fill Out Before Our Call
Your answers will shape our strategy session and ensure we make the most of our time together.
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1
What's your name?
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First Name
Last Name
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2
What is your number one fitness goal?
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Ex. "I want to see my abs before my trip in 4 months" or "I want to get ready for a bodybuilding competition"
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City, Country
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(ex. Toronto, Canada)
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Age
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5
Height and weight
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(ex. 5'10 240lbs)
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Weight in pounds
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7
What do you think your biggest challenge will be in reaching your fitness goal?
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(ex. lack of knowledge with nutrition, injuries, etc)
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8
How much of a priority are your fitness goals in relation to everything else in your life (1 indicating it is not a priority, 10 indicating it is a top priority)?
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9
What is your occupation?
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10
How physically active is your occupation on a scale of 1-10?
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Not physically demanding at all
Extremely physically demanding
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11
How physically active is your occupation on a scale of 1-10?
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12
How would you rate your level of stress on a daily basis?
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Low Stress
Unimaginable Stress
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13
How would you rate your level of stress on a daily basis (1 indicating low/no stress and 10 indicating high stress)?
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14
What areas of your life seem to cause you the most stress?
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Work
Home
Education
Finances
Health
Fitness
Social Life
Other
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15
What are your personal barriers to reaching your goals?
Select all that apply
Time
Motivation
Knowledge
Lack of Structure
Other
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16
What are your personal barriers to regular exercise and good dieting?
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17
Have you ever worked with a personal trainer or online coach? If yes, please describe your experience with them and how it went.
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18
How much experience do you have with weight training?
No experience
Less than 1 year
1-2 years
3-4 years
More than 5 years
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19
How much experience do you have with weight training?
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20
Are you currently doing any weight training? If so, please outline your routine.
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Please be as detailed as possible.
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21
Are you currently doing cardio? If so, what are you doing?
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22
How many days a week can you commit to a training program?
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23
How many days a week can you commit to a training program?
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I'm not sure yet, as my schedule varies.
1-2 times per week
3-4 times per week
5-6 times per week
I'm willing to commit to the gym daily.
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24
What are the best times during the day for you to train schedule and energy wise?
Mornings (anytime before noon)
Afternoons (noon - 5 pm)
Evenings (after 5 pm)
My schedule is flexible - I can fit in workouts at various times
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25
What are the best times during the day for you to train schedule and energy wise?
PREVIOUS
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26
Do you have any injuries? Are there certain exercises that you avoid?
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27
Describe in detail, a typical days worth of eating. Break it down meal by meal.
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BE SPECIFIC. If you do not have a current diet you are following, list out what a typical day would look like for you.
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28
Do you know your current macronutrient intake? (calories, fats, protein, calories) If so, please list
If you have no idea what this means, don't worry! Just skip this question.
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29
Have you been experiencing weight loss or weight gain in the last few weeks?
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30
Do you have any digestive issues? This includes bloating, pain, abnormal bowel movements.
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31
What foods do you love or hate? Do you have any food allergies?
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32
Are you on any prescribed medications? Please list
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33
Women Only, are you on birth control? Are you having a regular menstrual cycle?
Skip if not applicable.
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34
Please list any supplements you are taking
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35
Have you ever used or considered using performance-enhancing drugs (PEDs) for athletic or fitness purposes?
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YES
NO
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36
Can you please indicate the type(s) of performance-enhancing drugs (PEDs) you have used or considered using?
Anabolic steroids
Testosterone Replacement Therapy
Human Growth Hormone (HGH)
SARMs (Selective Androgen Receptor Modulators)
Prohormones
Fat burners/weight loss supplements
Other
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37
What were/are your reasons for using or considering using PEDs?
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38
Are you currently using any performance-enhancing drugs (PEDs)?
YES
NO
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39
Can you describe your current PED cycle?
Include substances used, dosages, and cycle length.
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40
Do you regularly get bloodwork done to monitor the impact of PEDs on your health?
YES
NO
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41
Are you currently, or have you recently, used performance enhancing drugs? If so, please list with experience.
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42
Do you drink alcohol or use recreational drugs?
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43
If available, please attach any current picture(s) of your physique
These will remain confidential. If you don't have pictures available at this time, skip to the question.
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44
I offer a limited number of 1-on-1 personal training sessions for those seeking highly-customized in-person coaching. These sessions have a premium cost due to their personalized nature and my limited availability. Are you interested in learning more about this option?
I believe I will need an in-person trainer.
I am confident in my ability to implement the workout plans independently in a gym setting
I'm not sure yet.
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45
Name
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First Name
Last Name
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46
Email
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example@example.com
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47
Phone Number
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Area Code
Phone Number
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48
Lastly, I'd love to know your specific expectations from a coach. Can you describe the ideal outcome that would leave you feeling truly happy with the progress you've made?
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49
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