Personal Details
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Date of Birth
-
Month
-
Day
Year
Date
Age
Current Weight (kgs/lbs)
Please include metric
Height (cms)
Lifestyle / Exercise background
Give us some detailed insight into your daily lifestyle and habits , please be as informative as possible .
Occupation (If applicable )
Rate your Stress Levels (Overall stress levels)
Very Low Stress in my life
Moderate Stress in my life
Moderate - High Stress
Extremely Stressed
Current Daily Activity Levels (Not including planned physical activity)
Sedentary (Little to no activity throughout the day)
Lightly active (spend a small portion of the day on your feet)
Active (spend a good portion of the day being physically active)
Very active (Spends a significant portion of the day being physiclally active)
How long since you participated in regular physical activity?
Currently Exercising
> 3 months
> 6 months
> 9 months
Current Weekly Exercise Regime
Let us know what type of exercise you are currently doing . If you are a current member of TRAIN Gyms or another gym please give us some insight into your weekly training schedule and the type of training you have been doing + for how long .
No.of Training days per week ?
Medical History
Do you currently or previously have any medical condition? (If yes, please describe)
Are you currently taking any medication ? (Please give description )
Do you currently have any injuries or have had a history of any such injury? (If Yes, Please Describe)
Do you currently smoke?
Dietary Requirements
Do you currently have any food allergies? (If yes, please describe)
Do you have any special dietary requirements? (i.e. vegetarian, lactose intolerant etc.)
Is there any foods which you dislike and would not like to be in the programme?
Goals and Objectives
Imagine : 6, 12,18 Weeks from now what would you like to have changed for you? Remember , change takes time and patience and consistency is key . This first 6 weeks is the starting point for you to become the best version of yourself !
Main Goal for this programme? (What do you wish to achieve from this programme?)
Disclaimer
Please consult with your health care provider or doctor before seeking nutrition and / or fitness consultation if any complications
Do you currenlty take any medication
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