Client Questionnaire

Please fill out the attached confidential questionnaire as accurately and honestly as possible. This will help me get a better feel for how I can better help you along your journey. Feel free to include as much information as possible. The more I get to know about you the better!

Basic Information


Current Fitness Activity

If so what kind of workouts and at what frequency?
(asthma, bad knees, bad wrists, etc)

Medical and Health Information

Lifestyle Information

Diet and Nutrition Information

If so, what supplements and what dosage?

Is there any other information that you feel I should know about your health, your eating habits, your exercise habits, food sensitivites, etc.?