Fitness Questionnaire

Please fill out the following form to help me understand your physical condition.

First Name

Age

Height

Weight

Last Name

Goal Weight

Weight 1yr Ago

When do you workout? What days specifically?

Minutes per day exercising? (Including cardio)

What time do you normally work out? If you are currently working out? Am or pm? What specific time?

Besides the gym how would you describe your daily activities? What do you do throughout the day?

Does your job require you sitting for more than 4 to 6 hours? workout? What days specifically?

Yes

Can you exercise during your work day?

Yes

How much cardio do you do in a week? Examples types of cardio?

How many meals do you eat regularly on a day basis?

What is a normal day of eating for you?

Do you have health concerns?

Food allergies?

What foods do you dislike?

Your favorite healthy food?

Do you drink alcohol? If so, how often?

Do you drink caffeinated beverages? If so, how often?

Do you use tobacco? If so, how often?

Do you take any vitamin, mineral, or herbal supplements, pre workout? How often, if so? Please list types and amount...

Do you have any injuries that may interfere with exercising?

What are your fitness goals?

I declare that the info I’ve provided is accurate & complete