Online Fitness Questionnaire
Basic Information
Full Name
First Name
Last Name
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Birthdate
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Height (feet, inches)
Current Weight (lbs)
Occupation
Daily Schedule/Work Hours
Hobbies
Workout History and Availability
Do you have access to a gym?
Yes
No
If yes, describe your gym and its equipment
How many days a week can you commit to working out?
2 days
3 days
4 days
5-6 days
What have you done in the past for your workouts? Please describe.
How long has it been since you've been active in a workout routine?
I have never been consistent in a routine
A few months
Over a year
Multiple years
I am currently in a consistent routine
How many hours a day are you able to spend in the gym?
45 min to 1 hour
1 to 1.5 hours
1.5-2 hours
2+ hours
Do you currently have any physical limitations or injuries I should know about?
Nutrition and Supplements
Please describe in detail what an average day of food and meals looks like for you, times you eat, what, how much
Back
Next
What are your goals? Select all that apply.
Lose Body Fat
Tone
Build Some Muscle
Build a lot of muscle
Lose weight
Improve health
More energy
Improve flexibility and balance
Build Strength
Improve Stamina and Endurance
Gain Weight
Please describe your fitness goals. Be as detailed as you can.
What is motivating you to achieve these goals?
Look and feel better
Improve health
Gain confidence
Fit into clothes better
Prevent health problems
Wedding or personal event
Other
Please describe what is motivating you to achieve these fitness goals
Why do you want to work with me?
Let me know your expectations of me as your trainer
Do you have questions for me?
How did you hear about me?
Friend referral
In person
Facebook
Instagram
Please upload 3 photos of your current physique, front, back and side. Its important to document your results with photos, and will help me program your training seeing where you currently are.
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