New Client Questionnaire Full Name * First Name Last Name How did you hear about us? Referral Google Search Social Media Yelp If other, please specify: Social Media: E.g. Instagram, Tiktok, Facebook, Twitter Date of Birth: Height: Current Weight: Occupation: Fitness Level: Sedentary, Lightly Active, Moderately Active, Very Active Do you have any pre-existing medical conditions or injuries we should be aware of? YES / NO. If yes, please specify: Are you currently taking any medications that might affect your ability to engage in physical exercise? YES / NO. If yes, please specify: Do you have any medical conditions or health concerns that might impact your dietary or training choices? (e.g., diabetes, high blood pressure, allergies) YES / NO. If yes, please specify: Do you have any known food allergies or intolerances? YES / NO. If yes, please specify: GOALS AND OBJECTIVES What is your goal weight? What are your primary nutrition goals? Weight Loss, Muscle Gain, Improved Energy, Overall Health What are your primary training goals? Strength, Muscle Gain, Endurance, Flexibility, Other Are there any areas of your physique you are particularly focused on? YES / NO. If yes, please specify: Are there any specific events or deadlines you are aiming to achieve your goals by? YES / NO. If yes, please specify: PHYSICAL ACTIVITY AND TRAINING Have you participated in any exercise programs or sports in the past? YES / NO. If yes, please specify: Have you worked with a personal trainer or fitness professional before? YES / NO. If yes, please specify: Are there any particular exercises or movements you are uncomfortable with or having difficulty performing? YES / NO. If yes, please specify: Are there any fitness activities you particularly enjoy or dislike? YES / NO. If yes, please specify: Do you currently have access to a gym or fitness equipment? YES / NO. If yes, please specify: Currently, how many times do you workout per week? On average, how long is each workout session? Taking into account your school or work commitments, how many days a week can you realistically commit to working out? 1-2 days, 3-4 days, 5-6 days NUTRITION How many meals do you typically consume in a day? 1 meal, 2 meals, 3 meals, 4 meals How many times do you snack throughout the day? What are your usual meal times? Describe a typical day: Do you consume alcohol? YES / NO. If yes, please specify: Do you smoke? YES / NO. If yes, please specify: How much water do you typically drink in a day? Do you consume other beverages regularly? (e.g., soda, coffee, tea) YES / NO. If yes, please specify: How often do you eat out or order takeout? Taking into account your school or work commitments, how many meals do you prefer to consume daily? Have you previously attempted a diet to either gain or lose weight? YES / NO. If yes, please specify: Are you familiar with tracking calories or macros? YES / NO. If yes, please specify: Have you engaged in meal prepping before? YES / NO. If yes, when and for how long: FOOD PREFERENCES AND DISLIKES Do you follow any specific dietary restrictions (e.g., vegetarian, vegan, gluten-free)? YES / NO. If yes, please specify: What are your preferred sources of carbohydrates? Quinoa Potatoes Oats Rice Whole grain pasta Fresh fruit Are there any types of carbohydrates you avoid? YES / NO. If yes, please specify: Do you have any fruit preferences or dislikes? YES / NO. If yes, please specify: What are your preferred sources of protein? Tofu Tempeh Chicken Turkey Beef Fish Eggs Greek yogurt (plan, low-fat) Are there any types of protein you avoid? YES / NO. If yes, please specify: What are your preferred sources of fat? Olive oil Avocados Nuts (e.g. almonds, walnuts, cashews) Seeds (e.g. flaxseeds, chia seeds, hemp seeds) Coconut oil Are there any types of fat you avoid? YES / NO. If yes, please specify: Is there any additional information you would like to share about your eating habits, preferences, training routines, or goals that might be helpful for creating a personalized nutrition and training plan? Thank you!
