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12 Week Program Form

This detailed form is the crucial first step. Your honest and thorough answers will allow me to design a truly individualised program (nutrition, training, and lifestyle) that maximises your results and fits seamlessly into your life ✨

Personal Info

What is your full name

Email?

Birthdate?

Height?

Current weight?

Occupation?

Goals and motivation

Please list and rank your top three fitness priorities (1 being the most important):

What is your desired timeframe for achieving your main goal?

What is your desired timeframe for achieving your main goal?
A
B
C

Do you have any current or past injuries, aches, or pains that I need to be aware of? (Please be specific about the location and severity.)

Fitness and exercise history

How many days per week are you currently exercising (including walks, gym, sports)?

Please describe your current exercise routine in detail. (What exercises do you do? How many sets/reps? How long are your sessions?)

If you go to a gym, what equipment do you have access to? (full commercial gym, limited free weights etc)

If training at home, what equipment is available to you?

What is your fitness experience level?

What is your fitness experience level?
A
B
C

Your program

What types of training would you like to have in your program?

What types of training would you like to have in your program?
A
B
C
D
E
F

Any specific training styles or exercises that you don't want to include in your program?

How much time can you realistically commit to training per week? (hours per week)

Which days of the week are you able to train? (select all that apply)

Which days of the week are you able to train? (select all that apply)
A
B
C
D
E
F
G

What is your preferred duration for a single training session?

What is your preferred duration for a single training session?
A
B
C
D

Nutrition and lifestyle

Do you follow any specific diet? (keto, vegan, vegetarian, gluten free)

How is your current relationship with food? (eg, Sustainable, restrictive, flexible, emotional eater)

What is your typical daily water intake? (litres/ounces)

On average, how many hours of sleep do you get per night?

How would you rate your typical sleep quality? (1=poor, 10=excellent)

How would you rate your typical sleep quality? (1=poor, 10=excellent)

How would you rate your current stress levels? (1=low, 10=high)

How would you rate your current stress levels? (1=low, 10=high)

Are there any major stressors currently impacting your life (work, family, etc.)?

Coaching Expectations & Commitment

What is your preferred method of communication with your coach?(e.g., WhatsApp, Email, App check-ins)

Do you have any questions for me before we start?

Thank you for completing this form. I will review your answers within 24-48 hours and be in touch directly with your tailored next steps!