How did you hear about A. Rae Fitness?
Any doctor diagnosed diseases/conditions:
List of current medications:
List of current supplements and vitamins:
Do you smoke? If so, how much per day/week?
Alcohol intake per week:
Current average water intake, in ounces PER DAY:
Current caffeine intake PER DAY:
Any food sensitivities/intolerances? If YES, what?
Are there any foods that you won't eat or don't like? This is important for a lifestyle and sustainability approach.
Current sleep: on a scale of 1-10, how would you rate the quality of your sleep?
How many hours per night, on average, of sleep do you get?
If interested in personal training, how many times a week are you looking for, what days/times?
Do you have a TOTAL MONTHLY budget you would like to stick with? If so, please list a range below.
1. What is your current activity level? (Lifting, cardio, sports?) Include how many days a week and length. Be specific.
2. What kind of job do you have? Sedentary or active? Explain what you do, how many hours a week you work.
3. What does an average day of eating look like for you? Start with breakfast, all the way to right before you go to bed. Be specific as possible and include snacks. This gives me a baseline of where we are at currently.
4. Weaknesses: Time of day/ type of food: Where are your struggle times of the day/experiencing the most cravings? When you do get cravings, what is it you crave? (Sweet, salty, fried, etc). Explain your downfalls and when they happen so I can coach you on how to avoid these times and how to prepare yourself for them.
5. This is probably the most important question: What are your short term and long term goals? What caused you to reach out? WHAT IS YOUR WHY? Be specific.
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