Chris Hughes PT Consultation

The information in this form is required to know a little more about you. To know what your goals are, know what your nutrition is currently like & lifestyle. From this we will be able to work on the plan to reach your goals. Please be as honest as you can 🙂
Enquiry Details
Name

First NameLast Name
Email
example@example.com
Phone Number
Format: (000) 000-0000.
Date of Birth

DayMonthYear
2 digit day, 2 digit month, 4 digit year
YOUR GOALS
What are your priority goals you would like me to help you with?
If other please explain below what help you are looking for specifically
Current weight
KG
Target Weight
Any Events coming up?
Holiday, Wedding, 5k
When is it?
6 months / Date etc
Your goals!
Drop dress size, sub 30min 5k
Any holiday commitments?
Holiday, Wedding, 5k
When is it?
6 months / Choose date etc
Your goal within 30 days?
Drop dress size, sub 30min 5k
What would you like to achieve in 3 Months?
Lose a stone, Learn how to exercise with good form.
In 6 months?
Run a half marathon, be confident going on holiday.
In a year?
Run a marathon, compete in a powerlifting comp
What would prevent you from achieving your goals?
If other please explain below.
Any minor injuries / tightness in muscles?
Tight quads, Tight Shoulders etc
If so how long has this been going on?
Days/ Weeks/ Months
LIFESTYLE AND NUTRITION
Do you smoke?
Yes / No
If so how many a day?
10 / 20...
Do you drink alcohol?
Yes / No
If so how often?
daily/ weekly/ weekends
What type of work do you do?
Sit at a desk, physical - labouring.
Full Time / Part Time?
8 hour day / 12 hour day
How much sleep do you get?
3 hours, 5 hours, 7 hours etc..
Preferred Training Times (ie: 6am/9am/3pm/late evenings etc)
I aim to accommodate days/times based on availability
What is your preferred style of nutrition? Calorie counting, Macro Counting, Food Plan or Other? (If other give example)
What do you have and at what time?
Lunch
What do you have and at what time?
Snack
What do you have and at what time?
Dinner
What do you have and at what time?
Desserts
What do you have and at what time?
Any Food Intolerances
Coaching Budget

Affordability
What is your monthly coaching budget? £150-£200, £200-£400, £400+
Thank you for taking the time to fill out this form. I will review your details and aim to get in touch within 24-48 hours with suitable coaching options & availability. Let me know if you want booked in for a free 10 minute consultation call to discuss a plan going forward. Take care, Chris
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Enquiry Details

YOUR GOALS

LIFESTYLE AND NUTRITION

Coaching Budget