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CLIENT GOALS
QUESTIONNAIRE
Name
Age
Email
Height
Weight
fitness history
How would you rate your current fitness level (1 = Unfit / 10 = Very fit)
*
1
2
3
4
5
6
7
8
9
10
How active outside the gym would you say you are?(1 = Not at all/ 10 = Very)
*
1
2
3
4
5
6
7
8
9
10
Please list the physical activities you participate in outside of gym and how often:
Do you track your diet? If yes, please specify your current caloric intake
*
Yes
No
Caloric intake
What has you current exercise routine looked like over the last 3 month ?
What type of equipment have you used ?
*
Free-Weights
Machines
Body Weight
No experience
Exercise related
Is there anything in your current training you have felt to be particularly beneficial ?
Is there anything in your current training you have felt NOT to be particularly beneficial ?
Are there any exercises you are unable to perform due to injury?
What rep range(s) per set do you typically perform in most ?
*
4-6
6-8
8-10
10-12
12-15
None
How sets per exercise do you typically perform ?
*
1
2
3
4
5+
None
How sets per exercise do you typically perform ?
*
1
2
3
4
5+
None
Please provide any other information you feel would be benefical for me to know in relation to your exercise habbits:
Developing your fitness plan
Realistically how many days per week can you dedicate to training ?
*
1
2
3
4
5+
Realistically how much time can you devote to each exercise ?
*
30 Mins
45 Mins
60+ Mins
How dedicted are you to achieving your goal? (1 = Not at all / 10 = Very dedicated)
*
1
2
3
4
5
6
7
8
9
10
If you answered anything less than a 10 to the above question, why? What would be required to make it a 10 ?
Are comfortable performing the main compound lifts (Deadlift, Squat and Bench Press ?
*
Yes
No
Please explain why.
what do you enjoy the most about training? Whats your motivation for working out?
Where would you like to see the most improvement ?
*
Upper Body
Lower Body
Mid-section
Endurance
All
What are you primary area(s) of interest ?
*
Improved Health
Improved endurance
Increased Strength
Increased Muscle Mass
Fat Loss
goal setting
Please list your specific fitness goals you would like to achieve. (Think short term and long term)
Is there anything in particular that would HELP in terms of adhering training plain?
Is there anything in particular that would HINDER in terms of adhering training plain?
Submit
Thanks for submitting!
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