Please copy the below questionnaire into your email or within our Facebook Messenger conversation to fill out the text and send when complete. Once I have all of the below information, pictures, measurements, and payment I will get right to work on your new plan!
Email address:
Phone number:
Physical Address:
Facebook & Instagram:
Age / DOB:
Food Allergies / sensitivities / aversions:
Provide a sample of your daily nutrition, including portion sizes, timing, food types, when you start and stop eatting:
Exercise history (past & current) Give a sample of what you do, timing & type, how many days a week:
Do you have previous experience with a personal trainer?
Goals: everything including: wish list, problem areas, upcoming events & time frames, injuries or imbalances that need correcting, desired weight and body composition, pictures of body types that inspire you…
Current weight & Height:
Where will you be training from? (gym or at home)
How many days per week can you commit to strength training?
Do you have any at home equipment?
Do you have any injuries or illnesses?
Are you currently taking any medication? (birth control, anti-depression / anxiety…)
Desired start date?
Further notes to be taken into consideration
We would like to work with your RMT (massage therapist), physiotherapist, Chiropractor, or other health care provider. Either yourself, or the care provider, can send us an email, with detailed notes on anything that should be considered in creating your new custom plan.
Feel free to indicate on the above diagram where you feel pain, or have had previous injuries, surgery, limited range of motion, etc.