Fitness Questionnaire

Copy and paste below into your email. Please answer in red color lettering.

See example below. Email bodiesbymary@gmail.com

First Name? Mary

Age?

Weight?

Height?

Male or Female (to put together the most medically accurate program for you)?


  1. What does your support system look like? (helps me understand your day to day)


  1. Are you taking any vitamins or supplements or medications? If so, please list why you are taking them. (medical reasons, could interact in your fitness or your nutrition)


  1. If you work, what is your job? Is it active or inactive? When’s your day(s) off? Example: stay at home parent. Example: I am a bank teller. Sometimes active. Sat & Sun off. (hold you accountable and help you schedule)


  1. What is your Fitness history? - last time you were in the gym, or played a sport, or how do you generally stay active Example: in the gym all the time but have no idea what i am doing. Example: walk the dog but used to play basketball in high school. (your starting point)


  1. Are you comfortable with machines or free weights like dumbbells, kettlebells, etc.? (your technique/form starting point)


  1. Any injuries or surgeries? -in your whole life- Example: none but knees will sometimes give out. Example: nothing current but when I was 5 I broke my left arm. Doctor said it was a Galeazzi fracture. (successful program and not expand on a potential unforeseen underlying injury.


  1. How can I guarantee you success? (so I know my approach I need to take with your program(s))


  1. Any injuries or surgeries? -in your whole life- Example: none but knees will sometimes give out. Example: nothing current but when I was 5 I broke my left arm. Doctor said it was a Galeazzi fracture. (successful program and not expand on a potential unforeseen underlying injury.


  1. How can I guarantee you success? (so I know my approach I need to take with your program(s))


  1. What are your expectations out of these programs? (make sure we are "on the same page")

What is your Fitness S.M.A.R.T. (Specific, Measurable, Attainable, Relevant & Timely) goal? (help achieve desired results faster)

Incorrect Example: walk more

Correct Example: To get more steps in over the next month, I will park two blocks away, walk for at least __ minutes __times per week, and get off the bus three stops earlier. I will also take my dog for a walk for __ minutes longer and take the stairs instead of the elevator.