Client Consultation Form
Please fill out this detailed form to help us understand your health, fitness, and lifestyle goals.
What is your full name?
First Name
Last Name
What is your age?
What is your height? (e.g., 170 cm or 5 ft 7 in)
What is your weight? (e.g., 70 kg or 154 lbs)
What is your occupation?
What is your daily activity level? (Sedentary, Light, Moderate, Active, Very active)
Do you have a current or goal timeline? (e.g., event, competition, vacation)
What is your primary goal?
Please Select
Fat loss
Muscle gain
Maintenance
Performance improvement
Other
Do you have a target weight, body fat %, or performance milestone?
How soon are you hoping to reach this goal? (e.g., in 3 months, 6 weeks)
Why is this goal important to you?
Are there any foods you’re allergic, intolerant, or sensitive to?
Do you follow any specific dietary style?
Please Select
Gluten-free
Dairy-free
Keto
Plant-based
Intermittent fasting
No specific style
Do you have any history of disordered eating or a complicated relationship with food?
How many meals do you typically eat per day?
What does a typical day of eating look like for you?
Are there any foods you love or hate?
Are you open to tracking your food/macros?
Yes
No
Do you drink alcohol?
Yes
No
If yes, how often?
Do you have any current medical conditions? (e.g., thyroid issues, PCOS, diabetes)
Are you taking any medications or supplements?
Have you had recent lab work done?
Any past injuries or surgeries?
Do you currently follow a workout program?
How many days per week do you train or move your body?
What kind of workouts do you enjoy?
Do you have any physical limitations or past injuries?
Do you have access to a gym or home equipment?
On a scale of 1–10, how committed are you to making changes?
1 (Not committed)
1
2
3
4
5
6
7
8
9
10 (Highly committed)
10
1 is 1 (Not committed), 10 is 10 (Highly committed)
What are your biggest struggles when it comes to fitness/nutrition?
What triggers you to fall off track?
How much sleep do you get per night?
How would you describe your stress levels?
Do you have support from family or friends in your health goals?
Do you like to cook, or prefer quick/simple meals?
Please Select
Like to cook
Prefer quick/simple meals
Do you grocery shop and prep your own food?
How many meals/snacks would you ideally like to eat each day?
Do you travel frequently or have an unpredictable schedule?
Are you looking for flexible dieting, or something more structured?
Please Select
Flexible dieting
Structured plan
What’s the best way to communicate with you?
Please Select
Email
Text message
App notification
How often would you like check-ins or feedback?
Are you looking for accountability, education, or both?
Submit
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