Assessment Form

1-ON-1 COACHING

Please fill in the form below so I can get a better understanding of what goals you hope to achieve from your 1-on-1 coaching

DOB

Exercise Hours Per Week

Height (cm)

Weight (kg)

Smoker?

Drinker?

Medications (prescribed)?

Allergies/Intolerances?

Any past/present injuries?

Vegan/Vegetarian?

Food Likes?

Food Dislikes?

Exercise Likes?

Exercise Dislikes?

What are your goals?

First Name

Last Name

Phone Number