Client Questionnaire

Answer in as much or little detail as you wish! The more detail, the more specifically I can help you. I have put (in brackets) which services each question applies to.

Which services would you like?

(All) In your own words, what would you like to achieve?

(All) Why would you like to achieve this?

(All) How much physically demanding activity do you do per week? Exercise, manual labour etc.

(All) What does this physical activity include? Weights, aerobics, walking, sports, gardening, work etc.

(Training Programmes) When, in your weekly schedule, do you do such physical activity?

Rows	00-06	06-09	09-12	12-15	15-18	18-00
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

(Training Programmes) If necessary, explain the ticked boxes in time order. E.g. if you first ticked Monday 09-12, this would be (1). If the next box ticked is Tuesday 18-00, this would be (2).

(Training Programmes & Nutritional Support) What is your height?

(Training Programmes & Nutritional Support) What is your weight?

(Training Programmes & Nutritional Support) What is your date of birth?

Date

(All) How much water do you drink per day (Pints)?

(All) Do you smoke?

(All) How many cigarettes do you use per week?

(All) How many years have you been smoking for? (If less than 1, put 1)

(Nutritional Support & Fitness Mentoring) Do you drink alcohol every month?

(Nutritional Support & Fitness Mentoring) How many servings of alcohol do you drink per month?

(Nutritional Support & Fitness Mentoring) How many years have you been drinking for? (If less than 1, put 1)

(All) Do you take any medication?

(All) Do you take any recreational drugs?

(All) If you take any medication or recreational drugs, it is your responsibility to explain to me what they are, if you believe I need to consider them in my services

(All) Please explain what drugs/medication you take and how it may affect your participation in my services.

(Training Programmes + Fitness Mentoring) What injuries or pains do you have?

(Training Programmes) Do you regularly get stiff or tight muscles? From work etc.

(Training Programmes) How many hours are you hunched over for/in positions bad for your posture? Desk work, sitting down, digging, cleaning etc.

(Training Programmes) Do you have access to the following?

(Training Programmes) Have you been regularly using the gym in the last 6 months?

(Training Programmes) Rate your gym confidence 1-10 (10 Being confident)

(Training Programmes) What areas of the gym are you happy to work within?

(Training Programmes) Name your three favourite exercises.

(Training Programmes) Name your three least favourite exercises.

(Training Programmes) Name the three exercises you feel the most confident doing.

(Training Programmes) Could you bring a partner to give you confidence to move into more-experienced areas?

(Training Programmes) Are you wary of other people watching you work out?

(Training Programmes) If you know roughly, could you explain some of your PBs?

(Training Programmes) At what times of the week can find time to work out?

(Training Programmes) How much training programme detail are you looking for?

(Training Programmes) How long would you like your workouts to last? (I don’t write ones over 2 hours normally)

(Training Programmes) If you are happy to, could you upload a photo(s) of yourself standing from various angles? This won't be shared anywhere else but would help me understand your posture. Boxers/shorts/sports bras are great to wear as they show more detail, but even fully clothed helps.

(All) Is there anything else you would like to mention & I should consider?

(Training Programmes) I use trainerize to provide 'follow-along' workouts for clients to follow for their ease. Are you willing to cover the monthly fee to use this? £10/Month in addition to my services. Either way, you will receive an excel spreadsheet of your workout plan which is yours forever. This can be used without the app but may be more difficult to use. Would you like to use the app?

(Training Programmes) What is your email?

(All) How can I contact you:

(All) Name

First NameLast Name

(All) Sex Stated On Birth Certificate