LIFESTYLE QUESTIONNAIRE

Please read the questions below carefully and answer each one honestly

Full Name

Date of Birth

Weight (kg)

Gender

Height (m)

Hip and waist measurements (if known)

Average daily calorie intake (if known)

What are your current health and fitness goals?

How active is your job and what is your average daily step count (if known)?

Describe your training and nutrition history

Do you have any food allergies, intolerances or dietary requirements?

Do you have access to a gym? If you are planning to workout at home, please list what equipment you have, if any.

How long can you realistically commit to working out each week (number of sessions and length of sessions)?

Is there anything else you feel I should know or would like to tell me that is relevant to your plan?

By accepting below, I confirm that I have read and understood to my full satisfaction and have completed this questionnaire. I also acknowledge that Ruth Kincaid Health & Fitness may retain a copy of this form for its records. In these instances, it will maintain the confidentiality of the same, complying with applicable law. Required

I ACCEPT

I DO NOT ACCEPT

Thanks for submitting! I'll be in touch very soon.