Lifestyle questionnaire
Name
First Name
Last Name
Date of birth
-
Month
-
Day
Year
Date
Gender
Please Select
Male
Female
Other
What would you like to achieve from taking part in the personal training programme?
Please describe your training history in the last two years
Rows
Cardiovascular Training
Resistance Training
Other
Frequency
Intensity
Time
Type
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Please describe your Current Training
Rows
Cardiovascular Training
Resistance Training
Other
Frequency
Intensity
Time
Type
Outline your availability to take part in physical activity/exercise (tick as applicable)
Rows
Mon
Tue
Wed
Thu
Fri
Sat
Sun
Morning
Afternoon
Evening
Do you have any particular equipment or exercise likes or dislikes?
How would you describe the following factors in your lifestyle?
Rows
Type details in here, the box will expand to fit your answer.
Nutrition
Sleep
Stress
Relaxation
Smoking
Alcohol Intake
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Next
Describe barriers which would prevent you from achieving your goals (e.g., finance, injury, motivation) and how you may overcome them
How would you describe your readiness to start an exercise programme?
What do you understand my role and responsibilities as your personal trainer to be?
What do you understand your role and responsibilities as a client to be?
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