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Juicy Bum Bum Client Questionnaire

01 PERSONAL DETAILS

Full Name

*

Date of Birth

*

Location / City

*

Occupation

*

Contact (WhatsApp, Email)

*

02 BODY & HEALTH

Height

*

Current Weight

*

Any injuries or pain?

*

Any health conditions?

*

Hormonal context

*

Current energy levels

*

Current energy levels

0

1

2

3

4

5

6

7

8

9

10

1 (Exhausted)510 (Excellent)

Sleep quality

*

Sleep quality

0

1

2

3

4

5

6

7

8

9

10

1 (Poor)510 (Excellent)

Stress level

*

Stress level

0

1

2

3

4

5

6

7

8

9

10

1 (Very calm)510 (Extremely high)

03 TRAINING HISTORY

How long have you trained consistently?

*

Current weekly training frequency

*

Where do you train?

*

Where do you train?

Commercial gym

Home gym

Mix

Equipment you have access to

*

Time of day you train

*

Favourite movements

*

Movements to avoid

*

Previous programmes used

*

04 GOALS

Primary goal in your own words

*

Specific body areas to prioritise

*

Areas NOT to develop further

*

Visual reference or inspiration

*

Timeline / key date

*

Aesthetics vs performance

*

Aesthetics vs performance

0

1

2

3

4

5

6

7

8

9

10

1 (Only aesthetics)510 (Only performance)

05 WHAT HAS & HASN'T WORKED

Best results you've ever had

*

What has never worked for you

*

Movements your body responds well to

*

Movements you dislike or avoid

*

Have you worked with a coach before?

*

Have you worked with a coach before?

A

Never

B

Yes — in person

C

Yes — online

D

Yes — both

What worked? What didn't?

*

06 LIFESTYLE

Occupation & daily activity level

*

Nutrition approach

*

Nutrition approach

No specific approach

High protein

Calorie tracking

Intuitive eating

Intermitted Fasting

Typical daily protein intake

*

Alcohol frequency

*

Alcohol frequency

None

1–2x week

3–4x week

Most days

Anything else affecting recovery?

*

07 EXPECTATIONS

What does success look like at 12 weeks?

*

What has stopped you from reaching this before?

*

Commitment level right now

*

Commitment level right now

0

1

2

3

4

5

6

7

8

9

10

1 (Just exploring)510 (Fully committed)

Preferred coaching style

*

How do you prefer to work together?
• Very structured: You want a strict, detailed plan.
• Flexible: You like a plan, but with room to adapt.
• Mostly independent: You prefer to do your own thing.
• High support: You want regular check-ins and close guidance.

Preferred coaching style

Very structured

Framework + flex

Autonomous

High contact

Anything else I should know?

*