Workout Plan: Coaching Questionnaire

Order No *

Name *

Email *

Gender *

Male
Female

Age *

You must be over 18 to start this program.

Height (ft) *

Weight (lbs/kg) *

Please state whether this is kg or lbs

How many years have you been training? *

How many days a week do you currently exercise? *

On average over the past 30 days

What does your current training routine consist of?

This will allow me to know what level of training you may need to begin with

How many days a week could you train? *

Please choose an amount you believe you will be able to sustain

What time would you prefer train? *

Morning
Afternoon
Evening
Night

How much time to you have available to train? *

45 minutes max
60-90 minutes
90+ minutes

If you've choose 45 minutes or less please expand on this in the details box at the end of the form.

What days are you unable to train?

What Type of Gym will you train at? *

PureGym/TheGymGroup
Bodybuilding Gym
Home Gym
Other Commercial Gym

If you train at home, please list all the equipment and weights you have below.

What current exercise do you do outside of the gym and how often per week?

e.g. sports, daily walks or runs etc.

Are you able to do pull ups?

Does your gym have any of the below?

Weighted Crunch Machine
Battle Ropes
Weighted Push Sledge

What's your current body type *

Slim/Skinny Fat Build
Average Build/Slightly Chubby
Overweight
Athletic/Muscular

What is your main goal? *

Fat Loss
Muscle Building
Strength Gain
Improve Fitness Level

List any weak areas you would like extra focus on *

E.g. small muscle groups or cardiovascular fitness level

If you have any, please list your favourite exercises to do

Where possible, I'll try implement these into your training plan

Are there any exercises you cannnot do, due to injuries etc...

Do you own a FitBit or Step Tracker? *

Yes
No

If no, please look into getting one. It doesn't need to be expensive just a basic step counter will do.

Do you currently track and know your daily calories? *

If so, please type the calorie number above

Do you currently cook most of your own meals? *

Always
Rarely
Never
My partner does

Real homemade foods e.g. not oven made frozen/processed foods

How often do you have takeaway? *

Once every 2-3 weeks
Once per week
Twice per week
Three+ per week

How active would you currently say you are? *

Very inactive (I spend most the day sitting/driving)
Not very active (desk job but I weight train or do long walks 1-2 times per week)
Active (fairly active job walking a lot and multiple training sessions per week)
Extremely active (multiple training sessions a week and a manual job)

Average hours of sleep per night? *

Less than 5 Hours
5-6 Hours
7-8 Hours

What are your 3 main goals you would like to achieve?* *

e.g. less stress, better sleep, feel confident, be stronger and/or lose weight

What are the 3 main obstacles currently in your way? *

e.g. short on time, making little progress in the gym, nutrition, motivation or maybe not sure what to do etc.

What do you think you need to ensure these obstacles are overcome? *

e.g. extra accountability, tough love at times or just someone to ask advice when stuck

How much of a push do you think you need right now? *

Barely any - I'm pretty self motivated, I just need guidance
Just a little - I need someone to keep me accountable
A fair amount - I can easily lose motivation and need someone to push me

E.g. In regards to you adhering to the coaching, as some may like a bigger push than others to stay on track

Any other details you think I should know?

Which Country do you live in? *

Just so I have an idea of times we can expect to get in contact with each other.

How did you hear about my services? *

Workout Plan: Coaching Questionnaire

Hey, thanks for purchasing my coaching package.

Please answer the below questions as best you can, so we can begin making progress.

The more detailed you are the more personalised and focused I can make the plan for you.