Online and Virtual Training Questionnaire

Online and Virtual Training Questionnaire
Welcome to the Better Mind - Better Body - Better Lift Community! I am super excited to work with you! Before we can get started, please fill out the questionnaire below. Please be as detailed as possible. The more I know about you, the better I will be able to tailor the program to your needs.
Name

First NameLast Name
Please provide FULL address incl Apt # if applicable. If your program includes workbooks we will use this address to send them to you.

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Country
Phone Number

Area CodePhone Number
Email
example@example.com
Occupation
Height
Current Weight
Do you smoke?
If yes, how many cigarettes per day?
Do you drink alcohol?
If yes, how often/much?
Are you pregnant?
If you have a child, were you ever diagnosed with Diastasis Recti after giving birth?
Physical Activity
Why did you decide to start a physical fitness training program and what do you expect?
What are your goals?
Did you work with a trainer before (online or offline)? If so, tell me about your experience.
Do you currently work out?
If so, how often?
If you currently work out, please describe exactly what you are doing (the more detailed you are, the better)
Do you have access to a gym?
Do you have exercise equipment at home?
If yes, please describe the equipment (e.g. free weights, resistance bands, stability ball, etc.)
Where do you want to do your workouts?
Which days of the week are you able to workout? Please check all available days. That doesn't mean you will have to workout on all of these days.
How many days per week are you (realistically!!) able to workout?
Do you have a fitness tracker (FitBit, Apple Watch, Garmin etc)?
Please describe your biggest challenges when it comes to working out
Nutrition
How many meals do you eat per day?
Are you vegan or vegetarian?
Do you have any kind of food allergies or restrictions?
If yes, please explain
What's your favorite food?
Do you take any supplements? If so, please list them.
Describe your biggest challenges when it comes to healthy eating
Psychological and Physical Well-being
Lack of appetite
Insomnia
Difficulty in Concentrating
Depression
Lack of Motivation
Fatigue
Stressed out
Other Information
Is there anything else I should know?
Should be Empty:

Online and Virtual Training Questionnaire

Physical Activity

Nutrition

Psychological and Physical Well-being

Other Information