Welcome to Adam Ballinger Fitness!

It's great to have you on the team and I can't wait to help you smash your fitness goals!

Let's get to work! But first, please fill out this form for me, it will give me the detailed information I need to construct your programmes specific to you based on your goals, wants and needs.

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Before you begin filling out the questionnaire, please make sure you have your 3 initial photos (front, side and rear shot) ready to upload, as you cannot submit the form with out them.

These need to be in boxers/short shorts for men, or a bikini for women. It would be ideal if you could be in natural lighting with a relatively plain background. These will be the starting pictures we will refer back to, so please ensure they are of good quality and well done!

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What is your full name?* This field is required.

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What is your email address?* This field is required.

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What is your mobile number?* This field is required.

Area Code

Phone Number

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What age are you?* This field is required.

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What is your bodyweight in kg?* This field is required.

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What is your height in feet/inches? * This field is required.Eg. I am 6ft 1in

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How would you describe your daily activity levels?* This field is required.

Sedentary - Seated most of the day

Moderate - Lightly active ie. walking often

High - Labour intensive

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Do you have any medical conditions or injuries I should be aware of, or exercises you cannot perform due to pain/injury?* This field is required.

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Are you currently cutting/bulking/maintaining? And how many calories are you currently eating?

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How many days can/do you currently train?* This field is required.

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How much cardio do you currently do, if any? And what type?* This field is required.

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How many steps do you do per day, on average?

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What cardio equipment/options do you currently have access to? (Even if its walking/running/cycling outdoors) Please list:

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Can you train twice a day if required? * This field is required.(This would usually be for a separate cardio session)

YESNO

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How many years have you been training for?* This field is required.

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What time of the day do you usually train weights? * This field is required.Please try to give rough times (it helps with nutrition programming)

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Do you prefer larger less frequent meals or smaller more frequent meals?* This field is required.

Larger less frequent

Smaller more frequent

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On a typical day, what times do you currently eat your meals?* This field is required.Please give specific times if possible...

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What supplements do you currently take?* This field is required.

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Are there any foods that you dislike? And any food that you really like?* This field is required.

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Please state the following measurements in inches...* This field is required.Chest Waist Mid bicep Top of thighs Mid calf

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When checking in can you please send pictures taken that morning whilst being in a fasted state, in natural light if possible. If it's dark and you do not have natural light then pleasure purchase a ring light, they are cheap and easy to get from Amazon. Please ensure all check-in pics are done in the same place with the same light and surroundings each week.

It is your responsibility to check-in, I will not be chasing you for this information so if you do not provide it, I cannot do anything about it. I get back to all check ins within 48 hours at a maximum, but usually they will be replied to within a few hours on the same day, including any relevant changes to the programme should they be required.

I will not change the programme if I am happy with progress, likewise if progress has plateaued, then changes will be made. If it’s not broken don’t fix it!

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Please add your first check in pictures (front shot)

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

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Please add your first check in pictures (side shot)

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

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Please add your first check in pictures (Back shot)

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

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By clicking continue I confirm the following; I am aware of and understand the potential risks associated with physical exercise and I am voluntarily partaking in these activities with knowledge thereof.

I have had the opportunity to ask questions regarding a change to my lifestyle. Any questions asked have been answered in full and I'm satisfied with the answers. I understand that all the information I have given is accurate and I will update my coach if anything changes for any reason.

I also confirm my understanding that no refunds will be offered once coaching has commenced aside from medical mitigating circumstances.

(PERSONAL TRAINING CLIENTS) - 24 hour cancellation policy, I require a minimum of 24 hours notice anything less and the session will be classed as used - sessions will be moved at my discretion in line with availability

sessions need to be used up by the end of the month - ie 12 sessions per month or they are not carried over.

By clicking continue I confirm the following; I am aware of and understand the potential risks associated with physical exercise and I am voluntarily partaking in these activities with knowledge thereof.

I have had the opportunity to ask questions regarding a change to my lifestyle. Any questions asked have been answered in full and I'm satisfied with the answers. I understand that all the information I have given is accurate and I will update my coach if anything changes for any reason.

I also confirm my understanding that no refunds will be offered once coaching has commenced aside from medical mitigating circumstances.

(PERSONAL TRAINING CLIENTS) - 24 hour cancellation policy, I require a minimum of 24 hours notice anything less and the session will be classed as used - sessions will be moved at my discretion in line with availability

sessions need to be used up by the end of the month - ie 12 sessions per month or they are not carried over.

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