Name *Email Address *Phone *Street Address *What is your occupation? *What percentage of your day is spent seated or sedentary? *How long have you been training consistently (if at all)? *Are you currently exercising? If yes, what does that look like? *Rate your level of gym confidence (1-10) *Rate your level of gym confidence (1-10)12345678910Have you had any significant injuries (anytime) or surgeries in the last five years? Including any broken bones, muscle tears, muscle aches, rehab treatments, birth, workplace injuries (Yes/no) *Please select an optionYesNoList any significant injuries and please describe your rehab in detail: *Do you have any medical conditions? (Yes/no) *Do you have any medical conditions? (Yes/no)YesNoWhat are they, and what medication is taken for the treatment if any: *Do you have any cardiovascular issues, high blood pressure, or joint conditions? *What are your goals in the gym? (Be specific, e.g. lose 5kgs or see muscle definition) *When do you want to achieve this by? *Why do you want to achieve this? (how would you feel if you reached this goal) *What do you want to learn? (Be specific, calories, macros, weight lifting) *If you are consistent for the next 12 weeks how would future you feel? *What has stopped you from achieving this goal previously? *What is your relationship with food like? Poor/okay/neutral/good/no issues *How many times do you eat per day? *What does a regular day of eating consist of? *Rate your daily sleep quality (1-10) *Rate your daily sleep quality (1-10)12345678910Rate your daily stress levels (1-10) *Rate your daily stress levels (1-10)12345678910How often do you drink alcohol? *Do you smoke? (Yes/no) *Do you smoke? (Yes/no)YesNoHow many days a week can you exercise? *Anything else you feel I should know to support you properly? *Submit
