Name
*
First Name
Last Name
Email
*
Mobile Number
*
Date of Birth
*
MM
DD
YYYY
Describe the goals you want to achieve, and why they are important to you
*
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?
*
Are you ready to get started in the next 1–2 weeks and commit to at least 12 weeks of coaching?
*
Are you ready to prioritise your health with real, sustainable changes — not quick fixes?
Height (cm)
*
Weight (kg)
*
Choose ONE of the below methods to determine muscle and fat mass, and body fat percentage
*
1. Skinfold Method – 9 Sites (in mm):
Pec, Ab, Thigh, Bicep, Tricep, Subscap, Suprailiac, Lumbar, Mid Axillary
I will calculate your body fat percentage from these numbers.
This is the most accurate method when performed by a skilled practitioner.
Can be done at any time of day, even after food — just ensure conditions are similar each time.
Do not measure after exercise — results will be skewed.
2. Home Body Composition Scale
Much more convenient!
I recommend this model: RENPHO ES-CS20M
Must be done early morning, ideally fasted, and never after exercise.
For reliable comparisons, scans should always be taken under the same conditions.
3. InBody Scan
Not the most reliable and usually costs $20–30 per scan.
Must be done early morning, fasted if possible, and never after exercise.
As always, aim for consistent conditions every time.
What do you think needs to be improved most with your current nutrition?
*
Would you prefer lot of structure, or a lot of variety and meals out, or somewhere in the middle?
*
Please choose an option:
*
Do you have any health or medical conditions or currently taking any medications?
*
Do you have any special dietary requirements, intolerances, or allergies?
*
Are there any foods you don’t want on your diet?
*
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)
*
Do you have a preferred protein powder you like or would you prefer not to have any included in your plan?
*
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
*
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?
*
Please outline a typical week of exercise if any
*
This might be walking, or weights, or pilates etc
Do you have any weight training experience?
*
Are you familiar and confident with deadlifts, squats, leg press, bench press? If you know your maximum bench press, squat and deadlift (heaviest weight for 1 to 10 reps) or any other compound exercises, please list below.
Are there any areas you feel you need to focus on or any known imbalances/weaknesses?
*
Please list all past and current injuries or surgeries if any.
*
What gym will you be training at? Or if training at home, please list the equipment you have
*
Are there any restrictions on what days of the week you can train on, or preferences?
*
Are you able to take videos for technique analysis and feedback regularly?
*
