Your name
Your email
Where have you found us from? Instagram (Alpha Athletics)Instagram (Other)Facebook (Alpha Athletics)Facebook (Other)Google (Website)Word Of MouthOther
If other, please specify
Age
Occupation
Weight in kg
Height in cm
Years of training experience
Lifestyle, Time Limitations (work commitments, family etc.)?
What is your body type? EctomorphEcto - MesomorphMeso - EctomorphMesomorphMeso - EndomorphEndo - MesomorphEndomorphI don't know my body type.
Body fat percentage? Below 10%In between 10% to 15%In between 15% to 20%Above 20%
On a scale of 1 - 10, how would you rate your motivation level? 12345678910
On a scale of 1 - 10, how would you rate your overall fitness level? 12345678910
On a scale of 1 - 10, how would you rate your overall stress level? 12345678910
Please list any medications you are currently taking (if any)
Do you have any injuries, health conditions, illnesses or allergies I should know about?
Meal 1 (Time and Content):
Meal 2 (Time and Content):
Meal 3 (Time and Content):
Meal 4 (Time and Content):
Meal 5 (Time and Content):
Meal 6 (Time and Content):
How many hours of sleep per night?
Are you currently or have you ever tracked your activity per day? If so how many steps on average?
How much water do you drink in a day?
How much alcohol do you drink a week, and what types?
Do you have any dietary requirements? i.e. vegetarian, vegan, gluten-free etc?
Are you currently or have you ever tracked your food intake? If so, how?
What factors do you know that you could do better?
Are you currently taking any supplements? If so please specify: what the supplement is, when you are taking it, how much you are taking and for what reason?
What is your top 3 mental barriers when it comes to your health & Fitness goals?
How does that make you feel?
What is your motivation? be as specific as possible ( 8 and 12-week short-term goals)
What obstacles do you see that may prevent you from reaching your health and fitness goals? Please specify (if any)? FinancialTime LimitationInjuriesMotivation & procrastinationOther
Are you 100% committed to getting results? YesNo
By undertaking training with Alpha Athletics & Aesthetics, I accept that this is based on a minimum 30 days length program.
Disclaimer, I, the undersigned, have read, understood, and have answered the above questions completely and truthfully. I am aware of my responsibilities to consult with my physician regarding my medical fitness to engage in any exercise practices. I do hereby intend to be legally bound and release all rights to claim for damages arising from my participation in the exercise program.
