Consultation form

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Name*

Age

Date of Birth

Height (CM)*

Gender*

Facebook Handle

Instagram Handle

Address

Phone*

Email*

Current Weight (KG)

Lowest Weight (past 12 months) (KG)

Highest Weight (past 12 months) (KG)

T-Shirt Size

Injuries (past & current)

Daily Average Step Count

Breakdown of training experience & outline what your training routine looks like at the moment

Please give below a snap shot of an average day of eating on a weekday or alternatively your current caloric intake. The more detail the better!

How many hours of sleep do you get on an average night ?

Are you a member of a gym, if so please specify? Please give a list of equipment that they have (the more detail the better).

What are your goals ? Give as much detail as possible

What have you tried in the past to achieve your goals? (courses, camps, books, coaches etc)

What exactly do you want from me as your coach in the next 3 months?

What is your “WHY” for starting this programme? (the more honest you are the better our result will be)

Is there anything that you feel I should know ?

Are there any specific areas of your body that you would like to improve on the most? (give a list and order in priority)

23. What is your primary overall goal?

Fat Loss (calorie deficit)

Muscle Gain (calorie surplus)

Other (please elaborate)

Please elaborate of selected other

Are you famililar with using MyFitnessPal & have you used it in the past?

What is your MyFitnessPal username?

Where did you hear about me?

Thank you for taking the time to fill out this form. Every question is important in giving you the best coaching experience possible. I’m really excited to start this journey with you!!

Consultation form

Consultation form

Enter your details below to arrange a consultation call with us