Name
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First Name
Last Name
Email
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Date of Birth
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MM
DD
YYYY
Address
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Please use one of the below methods for me to calculate your body fat percentage.
1. Skin fold method. I need 7 measurements in mm:
chest, abdominal, thigh, tricep, subscapular, suprailiac, midaxillary
2. Dexa / InBody / Evolt / Tanita scan
3. Tape measure method: I need 3 measurements in cms:
neck (widest point) waist (around belly button), hips (around bum)
Describe the goals you want to achieve, and why it is important to you
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In detail describe any of the following: your body composition goal; strength goals; lifestyle goals; habit goals (e.g. to look and feel fit and strong, be more consistent with drinking enough water each day, prioritising meal prep, and getting strong in the gym)
What has/has not worked for you in the past with regards to training styles?
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What is your main obstacle to achieving your goal?
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Would you describe your job as sedentary, moderately active, or very active?
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Are you currently exercising? If yes, please outline a typical week of exercise.
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Do you have any weights training experience, in particular with deadlifts, squats, leg press, bench press, seated military press? Please elaborate.
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What is your max barbbell bench press, barbell back squat and conventional/sumo deadlift? (1 to 10 rep maximum) or what is the most weight you have lifted recently (within the past 2-4 months)? If you are unable to do any of these exercises due to injury please provide similar best performances (e.g. best leg press weight & reps if unable to do barbell squats)
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Please list all past and current injuries if any.
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Where will you be training? (i.e. gym or home gym)
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Basic requirements for a gym are: barbell, squat rack, plates, dumbbells, adjustable bench, leg press, leg curl, leg extension, cable row, lat pulldown.
Please list the equipment you have if training at home.
How many workouts per week do you want?
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How did you find out about me?
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Referral
Web search
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