New Client Questionnaire
Full Name
First Name
Last Name
Email
example@example.com
Phone Number
-
Area Code
Phone Number
Height
Weight
Goal Weight
Age
Days per week spent exercising
0-1
1-3
3-5
5-7
Minutes spent exercising per session
0-30
30-60
60-90
90 +
Please tell me what type of exercise you currently do/have done.
Please tell me what a typical day is like for you (work, hobbies, etc.)
Please tell me about what you typically eat in a day. Also, let me know here if you have counted macros before, counted calories, done any type of diet (paleo, keto, Whole30, Atkins, Weight Watchers, etc.).
Please list any food allergies/intolerances here.
Please list any health conditions that I should be aware of when designing your program here (Diabetes, high blood pressure, etc.)
Please tell me about your health/fitness goals and what you would like to gain from working with me.
Additional comments/questions
Submit
Should be Empty:
Now create your own Jotform - It's free!
Create your own Jotform