CLient Questionnaire

Please take your time answering these questions.
Understanding you, your goals, your medical history, your athletic and nutritional background will help us better serve you.

NameEmail AddressAgeHeightWeight (in pounds)

Nutrition

If you track macros, what are you current macros?
If you do not track macros, please describe what you would eat on a typical day.With regards to diets, what do you think has worked well for you in the past? (ex. low carb, high fat diet)Do you currently take any supplements and/or preworkout?

Athletics

What is your athletic background?What are your short-term goals (3-12 months)?What are your long-term goals (1-5 years)?What is your current training routine?How many days per week do you train currently?How many days do you want to train?How many hours do you have available per training day?Do you have any experience with percentage based training programs and/or the RPE scale?YesNoHave you run a powerlifting or strength-focused training program before?
If so, please provide the name of the program(s) or programmer(s).
If you’ve ever had a trainer or coach before, how was your experience?
What did you like and/or what could have been better?What is your current 1 rep max for bench, squat and deadlift?
If not sure, what is the heaviest weight you have lifted and for how many?What do you like to do (favorite training movements)? What do you NOT like to do?What has worked before? What hasn't worked before?Do you have a training log or do you post your training videos to social media?
If so, please provide your usernames or direct links.

Mobility

What is your typical warm-up routine look like?Do you do mobility in or outside the gym? If so, please describe.Are there any areas of tightness or any movements that cause discomfort or pain?

Occupation & Hobbies

What is your current occupation?Does your occupation require extended periods of sitting?YesNoDoes your occupation require extended periods of repetitive movements?
If yes, please explain.Does your occupation require you to wear shoes with a heel like dress shoes?YesNoDoes your occupation cause you any anxiety or other mental stressors?Do you partake in any recreational activities (golf, tennis, skiing, etc.)?
If yes, please explain.Do you have any hobbies (reading, gardening, working on cars, etc.)?
If yes, please explain.

Medical History

Have you ever had any pain or injuries (ankle, knee, hip, back, shoulder, etc.)?
If yes, please explain.Have you ever had any surgeries?
If yes, please explain.Has a medical doctor ever diagnosed you with a chronic disease, such as coronary heart disease, coronary artery disease, hypertension (high blood pressure), high cholesterol or diabetes? If yes, please explain.Are you currently taking any medication?
If yes, please list medication(s).

Closing

What is most important to you when looking for a coach?
(ex: communication, technique or strength progression, etc.)How did you hear about us?

Thank you! We will review your questionnaire and follow up with you shortly.

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