Initial consultation - Metabolic Fitness: Experienced Personal Trainer in Chiswick

Personal Details:

Name*

Address*

Street AddressAddress Line 2CityZIP / Postal Code

Phone*

Email*

Enter EmailConfirm Email

Date of Birth*

Lifestyle

How much sleep do you get each night?*

Please enter a value between 0 and 16.

Describe your job?

Occupation?

Does your job require travel?*

Yes
No

How many hours do you spend sitting?*

Please enter a value between 1 and 18.

Rate your stress levels generally? Enter 1 = Low stress / 10 = High Stress*

Please enter a value between 1 and 10.

3 biggest sources of stress i.e. Work, Lifestyle or Lack of sleep*

What would you rate your current body shape? Enter 1=Not Ideal / 10 = Ideal?*

Please enter a value between 1 and 10.

What would you like your body to be? Enter 1= Not Ideal / 10 = Ideal*

Please enter a value between 1 and 10.

Fitness

When were you at your fittest?*

When were you last exercising regularly?*

What stopped you from getting fit in the past?*

Where would you rate your current fitness level? Enter 1 = Low Fitness / 10 = High Fitness*

Please enter a value between 1 and 10.

Where would you like your fitness to be? *

Please enter a value between 1 and 10.

Nutrition

Do you always eat breakfast?*

Yes
No

Do you ever skip meals?*

Yes
No

Do you eat late at night?*

Yes
No

How many glasses of water do you consume each day?*

Please enter a value between 1 and 10.

As a guide 2 litres is recommended especially when training

Do your energy levels drop during the day?*

Yes
No

Can you estimate how many calories you're taking in currently?

How many times a week do you eat out?

Do you have any allergies to foods?

Such as gluten, or any symptoms of bloating or lethargy

Personal Training

Have you had personal training before?

Yes
No

If Yes, What were you training for? What exercises were you doing with your previous trainer? Did you get results?*

List 3 goals you'd like to achieve with your trainers help?

When would you like to achieve these goals?*

How motivated are you to achieving these goals? Enter 1=Not Very / 10=Very

Please enter a value between 1 and 10.

Where would you rate health in your life?

Personal Training In Chiswick

Personal Details:

Lifestyle

Fitness

Nutrition

Personal Training

Additional Notes