Personal Details
Full Name
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First Name
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Date of Birth
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Address
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Street Address
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Other
Country
Gender
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Male
Female
Weight (kg or pounds)
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Height (cm)
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Which coaching package are you applying for?
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Standard
Semi-Online
Premium Online Coaching
Training History
How long have you been lifting weights?
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I don't lift yet
0-6 months
6 months - 1 year
1-2 years
2-3 years
3-5 years
5 years+
How long have you been continuously exercising for (without a break of more than 2 weeks)?
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1-2 months
2-3 months
3-6 months
6 months - 1 year
1-2 years
2-3 years
3 years+
How many times per week are you currently exercising regularly?
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1
2
3
4
5
6
7
Please describe your current training routine in as much detail as possible, making sure to include weights & cardio sessions.
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Please list your favourite and least favourite exercises and why?
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Give details of any injuries, mobility issues or exercises that cause pain discomfort.
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Your goal
My main goal is
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Increasing Strength
Muscle Gain
Fat Loss
Sports Performance
Health Improvement
Other
Please give further details regarding your goal and what you would like to achieve in the long term.
*
Give details of any time specific goals you may have and explain why the time-frame is important
How many times per week could you train?
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1
2
3
4
5
6
7
How long can you train for in each session?
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30 minutes
30-45 minutes
45-60 minutes
60+ minutes
Lifestyle
What time do you prefer to train?
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First thing in the morning
Mid morning
Afternoon
Evening
No preference
Rate your energy levels during the day
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Very tired all day
Very tired at certain times during the day
Average
Good energy most of the time
Feel energetic all the time
Please describe your sleep habits in as much detail as possible, including bed & wake up time, quality of sleep, any sleep interruptions etc
*
Current occupation
*
Daily activity level (excluding exercise)
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Sedentary \ Inactive - (Mostly sitting)
Moderately active - Long periods of standing or walking
Strenuous - Manual labour
Typical working hours shift pattern
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Current Stress Level
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1
2
3
4
5
6
7
8
9
10
What are the main stressors in your life (work, family etc)?
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Please provide details of any sport you undertake regularly as well as details of matches & training
*
What hobbies do you have other than sports or exercise?
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Which days are you able to consistently submit your updates (please select all possible days)?
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Monday
Friday
Tuesday
Saturday
Wednesday
Sunday
Thursday
Nutrition
How often do you shop for food?
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Daily
1-2 times per week
2-4 times per week
Weekly
Fortnightly
Monthly
How often do you eat out?
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Daily
Several times per week
Weekly
Fortnightly
Monthly
Rarely
Never
How often do you eat fast food?
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Daily
Most days
Weekly
Fortnightly
Monthly
Rarely
Never
How often do you drink alcohol?
*
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Daily
Most days
Weekly
Fortnightly
Monthly
Rarely
Never
Please describe your current food intake and provide your cuurent macro & calorie breakdown if known
*
Please list any foods that you cannot eat for medical reasons
What are your favourite foods?
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What foods do you dislike?
*
My cupboard fridge freezer is full of
*
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Entirely processed or packaged foods
Mostly processed or packaged foods
An even split of processed and whole foods
Mostly whole foods
Entirely whole foods
How many hours per week do you have to prepare food?
*
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1
2
3
4
5
6
7
Please provide details of any supplements you are taking and the amounts
Social support
How do you feel when you look in the mirror?
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How supportive do you feel your friends & family will be? What do they think of your goals?
*
How supportive are your work colleagues? What challenges will your working environment bring you?
*
Describe what your motivation is for this change?
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