Name: *

Surname: *

Phone: *

Age: *

Number Of Years Training: *

Goal: *

Current Physique Photo: *

What's your social media handle?:

Current Weight (Fasted): *

How tall are you?: *

Describe what you currently consume on a day to day basis?: *

Do you know your current Calories/Macros? If so please provide:

What do you consider to be foods that you MUST have. (e.g. Chocolate, Coffee etc) ?: *

What foods/drinks do you dislike? : *

Do you have any of the dietary restrictions or allergies?: *

How would you rate your current physical activity?: *

Please describe your cooking experience/abilities. These may include the use of stove/oven/microwave/air fryer etc: *

Please describe your common day schedule/activities that affect when/how you eat your meals. ( e.g. tradesman with no access to microwave for lunch / limited preparation time for breakfast): *

Please tick which of the following high protein foods you like:: *

Please tick which of the following high fat foods you like:: *

Please tick which of the following high carbohydrate foods you like:: *

Please tick which of the following Fruits you like:: *

Please tick which of the following Vegetables you like:: *

What type of meals do you enjoy eating for Breakfast? ( e.g eggs on toast / Smoothie): *

What type of meals do you enjoy eating for Lunch? ( e.g. Chicken Wrap): *

What type of meals do you enjoy eating for Dinner? ( e.g. Steak and veggies): *

What type of snacks/sweets/desserts do you enjoy eating?: *

Are you currently taking any supplements? (e.g. Fish Oil, Creatine, Vitamin B Etc): *

If you are currently taking any medications such as prescribed meds or PED's, please list the type, frequency, dosages and how long you have been taking them.: *

Where do you mainly do your grocery shopping? (Coles/Woolworths/Aldi): *

Do you prefer to eat large meals, small meals or a combination of meals and snacks?: *

Is there anything you would like to mention in regards to you diet?: *

Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?: *

Do you feel pain in your chest when you do physical activity?: *

In the past month, have you had chest pain when you were not doing physical activity?: *

Do you lose your balance because of dizziness or do you ever lose consciousness?: *

Do you have a bone or joint problem that could be made worse by a change in your physical activity?: *

Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition?: *

Do you know of any other reason why you should not do physical activity?: *

How long have you been training /exercising?: *

How many days per week are you available to exercise?: *

Are you currently following a training program? If so please provide details: *

What are you hoping to achieve from your training program?: *

What facility or equipment do you have access to?: *

For the answer above please indicate what equipment you are competent in using.: *

Do you currently track your steps? If so, Whats your current average per day?: *

Are their any lifestyle/social or economical barriers that may affect your ability in achieving your training goal?: *

Are their any exercises you are not competing and performing?: *

Do you have a preference in coach? (Tom or Amanda): *

When are you looking to start your coaching with us ?: *

Is there anything additional you wish to add regarding your training ?:

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