Name
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First Name
Last Name
Email
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Mobile Number
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Date of Birth
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MM
DD
YYYY
Describe the goals you want to achieve, and why they are important to you
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This could be related to body composition/strength/confidence/overall health
Are there any obstacles you've encountered in the past that prevented you from achieving this goal or a similar goal in the past?
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Have you tried coaching or programs in the past? If yes, what worked / didn’t work?
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Are you ready to get started in the next 1–2 weeks and commit to at least 12 weeks of coaching?
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Are you ready to prioritise your health with real, sustainable changes — not quick fixes?
Height (cm)
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Weight (kg)
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What do you think needs to be improved most with your current nutrition?
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Would you prefer lot of structure, or a lot of variety and meals out, or somewhere in the middle?
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Please choose an option:
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Do you have any health or medical conditions or currently taking any medications?
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Do you have any special dietary requirements, intolerances, or allergies?
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Are there any foods you don’t want on your diet?
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Are there any foods you do want on your diet? For example your favourite bread or yoghurt, or milk for your daily coffee (provide brand details or website links)
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Do you have a preferred protein powder you like or would you prefer not to have any included in your plan?
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It's not absolutely necessary for the purpose of muscle gain/fat loss, but is an easy way to top up total daily protein.
List all the foods and drinks typically consumed in one day, including supplements, and water intake
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If it varies a lot, give me 2 example days. Please provide as much detail as possible.
Are you mostly sedentary, moderately active, or very physically active each day?
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Please outline a typical week of exercise if any
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This might be walking, or weights, or pilates etc
Weight training experience and best performances:
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Do you have experience with deadlifts, squats, leg press, bench press? If known, what is your best bench press, squat and deadlift? (i.e. the heaviest weight you've done for between 1 and 10 reps)
Are there any areas you feel you need to focus on or any known imbalances/weaknesses?
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Please list all past and current injuries or surgeries if any.
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Which gym will you be training at?
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I will look it up online to check equipment inclusions. If training at home - please list your equipment and the total weight you have in plates, and what weight dumbbells you have.
Do you have a preference for what days you train on?
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Are you able to take videos for technique analysis and feedback regularly?
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