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JBS CLIENT SIGN-UP FORM
Online Coaching & Personal Guidance.
Please complete the following questionnaire as honestly as possible. This information helps JBS tailor your programme, nutrition, and guidance to your goals and lifestyle.
1. Let's start with your personal details
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Gender
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Gender
A
Female
B
Male
Age
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2. Health & Medical Information
Do you use any chronic medication?
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Do you use any chronic medication?
A
Yes
B
No
If you selected yes above, please elaborate in the text box below. If you selected no in the above then just type N/A.
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Do you have any injuries or medical conditions we should know about?
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Do you have any allergies or food sensitivities?
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3. Exercise & Lifestyle
How active are you currently?
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How active are you currently?
A
Not active - little or no exercise
B
Lightly active - exercise 1–2 times per week
C
Moderately active - exercise 3–4 times per week
D
Very active - intense training 5+ times per week
How comfortable are you with exercise?
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How comfortable are you with exercise?
A
Beginner
B
Intermediate
C
Advanced
Do you have access to a gym or training facility?
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Do you have access to a gym or training facility?
A
Yes
B
No
Other
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How much time do you have available to train per week?
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4. Nutrition & habits
How would you describe your current eating habits?
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What foods do you enjoy eating?
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What foods do you dislike or avoid?
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If you do consume alcohol, how much per week do you consume?
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If you do consume alcohol, how much per week do you consume?
A
I do not consume alcohol
B
Occasionally - a few drinks per month
C
Weekly - mostly on weekends
D
Regularly - several times per week
Do you eat or drink a lot of sugar during the day?
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Do you eat or drink a lot of sugar during the day?
A
Yes
B
No
C
Sometimes
5. Goals
What is your main goal with JBS Coaching?
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What is your main goal with JBS Coaching?
Weight loss
Muscle building
Getting fitter
General health
Sport performance
Other
If you selected other in the above, please elaborate in the text box below.
Please sign in the block below.
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Signature
Sign-up
