Name
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First Name
Last Name
Email
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Location
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Who referred you/How did you find me?
Gender
Date of Birth
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DD
YYYY
Height
Weight
Occupation
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Do you travel for work? If yes, how often?
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Relationship Status & Children?
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Are you Pregnant?
If yes, what is your estimated due date?
Please list in order of priority your life, wellness and performance ambitions for the next 3-12 months.
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Describe any perceived limitations to achieving your goals.
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Please list any special events in the next 3-12 months (weddings, moving houses, child birth, vacations, graduations, etc.).
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Describe your current training/exercise.
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What do you do to relax and have fun?
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How many days per week can you commit to exercise? How many hours each session?
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Describe your morning routine.
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Describe a typical work day
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Describe your evening routine.
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Do you track/monitor HR, Energy Output, Steps, Sleep Quality etc. Via Wearble Tech?
Please describe your current nutritional habits. If possible, include average calories, carbs, protein and fats. If unknown, list a typical day of eating for you.
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Do you smoke and/or drink? If yes, how much and how often.
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Do you have any injuries or ailments that impact your life or training?
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Do you have any medical conditions I should be aware of?
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Do you have any digestive related issues that I should be aware of (food allergies, food intolerances, ulcers, chronic diarrhea, IBS etc.)?
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On a scale of 1-10, how serious are you about achieving your goals?
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Anything else I should know?
