Pre-Consult Questionnaire
The following questionnaire is designed to collate as much information as possible to help your coach understand your needs. Given the depth of the questionnaire, not all questions may apply to you so don't worry if you're unsure about how to answer some of the questions.
Personal Information
Name
First Name
Last Name
Email
example@example.com
Phone Number
-
Area Code
Phone Number
Date of Birth
-
Month
-
Day
Year
Date
Height
Bodyweight (in morning after voiding)
I am interested in
Weekly Coaching
Block Coaching
Nutrition Only Coaching
Unsure, I'd like to chat about it
Are you willing to invest in your health? You only have 1 body (so let's look after it).
Hell yes
Need to chat about it
How long are you willing to invest? Please note our coaches are not here to provide a quick fix.
16 weeks
6-12 months
More than 12 months
Not really sure
Are you inquiring for a specific coach?
Matt
Will
Don't mind
How did you hear about us?
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Your Goals
What do you want to achieve? Muscle gain, lose fat, look better physically, be more athletic etc
Why do you want to achieve this?
How long do you think this will take?
What limitations/obstacles are currently preventing you from achieving this?
What do you foresee as potential reasons for not reaching your goal?
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Your Training
How many days can you train per week? (be realistic, select a frequency that you can stick to when you're at your busiest)
2
3
4
5
6
How long can you dedicate to each of your sessions?
40mins
60mins
80mins
as long as it takes
Please select your training experience
I've never trained before
Beginner (1-2 years of consistent/structured training)
Intermediate (2-5 years of consistent/structured training)
Advanced (5+ years of consistent/structured training)
Do you currently follow a training program? If so please send to admin@3pointperformance.com.au
What does your gym have:
Barbells and racks
Dumbbells
Cables
Weight stack machines
Plate loaded machines
Other machines
Please list your CURRENT training weights for these exercises if you perform them, mention any variations if appropriate
BB Squat
BB Bench Press
BB Deadlift
BB RDL
DB Press
DB Shoulder Press
Other
Do you perform any cardio currently?
Are you currently tracking your daily step count? If so, please outline your average daily number of steps.
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Your Nutrition
Provide a detailed day of current eating (All meals and snacks)
Do you know what calories/macronutrients are? If you have tracked food before, how long have you tracked for? How confident are you with tracking /10?
Do you have any food allergies or intolerances that have been medically diagnosed?
What would stop you from adhering to a nutrition protocol?
Have you recently dieted or been in a gaining phase? Please provide detail. Length of diet/ gain, when it was, how did you run it?
How many meals works best per day with your schedule? What times are best for you to eat? Include snacks such as pre workout snacks.
Can you tell me 5 types of lean protein sources? Do you include these into your daily/ weekly meals?
Can you tell me 5 types of low calorie and nutrient dense foods? Do you include these into your daily/ weekly meals?
What are you favourite vegetables (name 5) and favourite fruits (name 3)?
Have you previously had any eating or body image related issues, such as binge eating disorder?
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Your life
What is your occupation? Are you sedentary or active at work?
What is your sleep duration and quality like?
Do you drink alcohol regularly? If so, how much?
How are your stress levels generally?
What is your proudest moment in life?
Who inspires you the most?
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