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Summarized Consult Questions
Full name:
Pronouns:
Age:
Email address:
Briefly describe your current and previous fitness routine/interests.
What are the top 2 to 3 things you would like help with?
Do you have any existing injuries, conditions, or chronic aches that I should be aware of while building your training plan? If so, please be as detailed as possible. Helpful information: When it started, exact location, current pain level, when it flares up, original cause (if known), etc.
Please feel free to share any responsibilities, commitments, activities, and/or hobbies that are prioritized highest in your life.
Medications? Allergies?
Sleep: how many hours do you average per night?
Nutrition intake: How prominent are fruits and vegetables in your daily intake? Roughly how many servings of vegetables would you estimate you eat daily?
Meal times: When do you typically eat? (average time of both meals + snacks)
Digestion: bowel movements - regular/ irregular? (regular: every morning upon waking - average 1-2x per day).
Hydration: On average, how much water do you drink per day?
Caffeine consumption: do you drink coffee or other forms of caffeine? yes/no. If yes, how many cups/ounces per day?
Alcohol consumption: yes/no. If so, how often?
Tobacco use: yes/no. If so, how often?
Rate your overall stress level on a scale from 1-10.
Do you have a support system that would know about your new devotion to a fitness coaching routine? If comfortable, feel free to list their relationship to you + names.
How would you describe your best, most authentic self? Which of those traits do you especially hope to nurture through the process of taking care of yourself?
List any additional comments about what you would like to see in your movement program and achieve through the coaching process below if not already covered.
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