Online coaching questionnaire
This information is essential to assess and program for your success.
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
What are your primary goals? (Be specific)
On a scale of 1-10 how committed are you to reach these goals?
What is your target timeline for seeing results?
Have you ever hired a coach before?
Yes
No
If yes, what did you like/dislike about the experience?
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How many days per week can you train?
2-3 days
4 days
5 days
6 days
It varies
How many minutes do you have per workout?
30 minutes or less
45 minutes
60 minutes
75+ minutes
Current activity level (outside of working out)
Sedentary
Lightly active (5k-8k steps)
Moderately active (8k-10k steps)
Very active (12k+ steps)
Daily average hours of sleep
4-5 hours
6-7 hours
8 hours
8+ hours
How would you rate your quality of sleep on a scale of 1-10? (10 being the best)
Stress level 1-10 (1 being the best)
What is your main source of stress?
Do you currently track your food?
Yes
No
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Do you have any current injuries, pain, or medical conditions? (e.g. lower back pain, knee issues, shoulder impingement, high blood pressure, diabetes, thyroid issues, etc.)
Yes
No
If yes, please describe in detail (what, when, any limitations, or doctors advice
Are you currently taking any Supplements or medications?
Yes
No
If yes, list them:
Any food, allergies we intolerances? (e.g. dairy, gluten, nuts)
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How would you describe your eating habits?
Very healthy
Mostly healthy
Average
Not great
Poor
How many meals and snacks do you typically eat per day?
List any foods you don’t like:
How much dime do you have for meal prep per week?
1-2 hours
3-4 hours
5+ hours
None
What is your biggest nutritional challenge right now? (e.g. emotional eating, busy schedule, cravings, etc.)
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How long have you been consistently training?
None
0-6 months
6-24 months
1-2 years
2+ years
What type of training do you enjoy or prefer?
Strength training (weights)
Calisthenics (body weight movements)
Cardio (running/cycling)
HIIT
Yoga/mobility
Other
Do you have full access to: (check all that apply)
Full gym
Home gym
No equipment
Outdoor space
Any exercise(s) you absolutely hate doing?
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What motivates you to reach your goal?
What has held you back from achieving your goals in the past?
How do you order to communicate? (Voice note, video calls, Instagram, phone calls, etc.)
I confirmed that the information provided is accurate to the best of my knowledge. I understand that online coaching it’s not a substitute for medical advice, and I take full responsibility for my health and safety.
Submit
Submit
Should be Empty: