NextLevelLean – Client Questionnaire
Answer a few questions about your goals, training, and health so I can guide you effectively.
About You
Full Name
*
First Name
Middle Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Date of Birth
*
-
Month
-
Day
Year
Date
What do you do for work?
Goals & Motivation
What are your main fitness goals?
*
Fat loss
Muscle gain
Improve general fitness
Other
Describe your goals in more detail – what does success look like for you?
*
What made you decide to get a coach right now?
*
What do you struggle with most when it comes to fitness?
*
Training
Diet
Consistency
Recovery
All of the above
What do you aim to gain specifically from working with me?
*
Training Background
How would you rate your current fitness level?
*
Beginner
Intermediate
Advanced
How many days per week do you currently exercise?
*
Please Select
0
1
2
3
4
5
6
7
What does your current training look like?
Are there any exercises or training styles you enjoy or dislike?
What days and times are you available to train?
Is there anything that currently stops you from training consistently?
Medical & Physical
Do you have any current or past injuries?
*
Yes
No
If yes, please describe them.
Do you have any health conditions your trainer should be aware of?
*
Yes
No
If yes, please provide details.
Are you currently taking any medications?
*
Yes
No
If yes, please list them.
PAR-Q Declaration
*
I confirm I am medically cleared to participate in physical exercise, or will seek GP clearance before beginning.
Nutrition & Lifestyle
How would you describe your current diet day-to-day?
*
What do you struggle with most when it comes to nutrition?
*
Staying full
Cravings
Skipping meals
Knowing what to eat
Overeating
Other
Do you know your rough daily calorie or macro intake?
*
Yes
No
If yes, please share your approximate daily calorie or macro intake
How many steps do you roughly do per day?
*
Under 2,000
2,000–5,000
5,000–8,000
8,000–10,000
10,000+
How many hours do you sleep per night?
*
Please Select
Less than 4
4–5
6–7
8+
How would you rate your sleep quality?
*
Poor
Average
Good
Do you smoke, drink alcohol, or use any substances?
*
Yes
No
If yes, please share brief details
Do you have a rough weekly food budget?
*
Yes
No
If yes, what is your rough weekly food budget?
Services & Next Steps
Which service are you interested in?
*
1:1 In-Person Personal Training
Online Coaching
Not sure yet
When are you looking to start?
*
As soon as possible
Within the next month
Just exploring for now
How did you hear about me?
Instagram
Google
Word of mouth
Other
Is there anything else you'd like me to know before we speak?
Submit
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