ONLINE TRAINING QUESTIONNAIRE

Name

First Name

Last Name

Age

Height

Weight (in lbs)

Optimal Weight

Are you a previous client of ours?

Yes

What does your current fitness routine look like? Is it:

What are your goals?

Increase strength/lean body mass

Increase muscular endurance

Fat loss

General health

List your food allergies or if you are vegan or vegetarian

What are your favourite healthy foods? **Please list in point form**

What are your favourite unhealthy foods? **Please list in point form**

What foods do you dislike? **Please list in point form**

Provide a 1-2 day food journal. If weekdays and weekends are very different, record one day of each. Include: quantities (ex. 2 cups cherrios + 1 cup skim milk) and what time you ate each meal/snack.

How did you hear about Thrive Active?

Social Media

Referral

Search Engine Listing