PRE EXERCISE APPRAISAL

Name:

Please note that there are no right or wrong answers here – just be totally honest so that I
can best help you to reach your goals. The better I understand you, the better placed I am to
give you the best coaching specific to you and your unique needs.

General

1.What would you like to achieve by working with a trainer and why is this important to
you?

2.What are you willing to do to make this a reality for you?

3.Do you view yourself as being a person capable of exerting self discipline?

4.Have you had any previous injuries / medical complaints that could impact upon an
exercise regime?

5.How would you rate your overall health? (please ensure to expand on this in PAR-Q)

6.Does your family have any history of medical conditions? I.e. heart disease, dia-
betes, stroke, cancer?

7.Please tell me about your previous exercise and sporting history. Have you ever had
personal training before? – Please be as detailed as possible here. Use a separate
page if necessary.

8.To help me conceptualise your body composition goals, is there a person out there
who you would most like to (physically) emulate (sports star/celebrity)?

9. How do you want to feel at the end of a workout:

a. Leaving with something in the tank. Just enough to feel it.

b. tough but not totally exhausted. Pushed with a little to spare.

c. everything you’ve got. Go hard or go home mentality. Bring on 2024!!

10. Is there anything physically that you cannot do, that you always wished you could
do?

Nutrition

11.Have you lost weight before? If so what did you follow a specific diet? What did you
do?
12.How many times do you eat per day? including snacks?

13.Do you regularly eat breakfast? If so what do you eat?

14. What time is your last meal?

15. How do you feel after having lots of carbohydrates, especially gluten/wheat based
products (ie bread, pasta, cereal etc– Please tick that applies

16. Do you eat and drink any dairy or soya products?

17.Do you ever get any food cravings? Sweet or salty?

18.How often do you cook for yourself?

19.How often do you eat takeaway or ready meals?

20.How often do you eat out at restaurants or fast food outlets?

21.How many cups of tea/coffee/energy drinks per day do you have? Milk and sugar?

22.Do you drink alcohol? If so how often and quantity per week?

23.Do you or have you used any recreational drugs, performance enhancing supple-
ments or are on any prescription medicines

24.Have you or are you using any oral or injectable contraceptives? If yes and you have
since stopped when did you stop?

25.How much water do you drink during a day (is it bottled or filtered/brita?)

26.Do you have any food allergies or special religious dietary requirements?

27.Do you currently take any sports or health supplements/vitamins?

28.Would you say your emotional state affects the way that you eat and if so what you
eat when this happens?

29.Please give me an overview of a days eating for you, use a separate page if neces-
sary (go to last page)
Digestion

30.How frequent are your bowel movements?

31.Do you have loose, normal or hard stools? Is it easy for you to use the toilet?

32.Do you get any bloating, indigestion or acid reflux? Using any anti acids?

Lifestyle

33.What is your occupation and how many hours do you work?

34.How active are you physically at work?

35.How would you perceive your level of stress? (1low-10high)

36.Does your job entail you eating and drinking out a lot (i.e. to entertain clients, beers
after work with colleagues)

37.Do you commute? If so what method and how long does it take every day?

38.How many late nights socially per week do you have?

39.Do you have more energy in the morning or the evening?

40.Do you have trouble switching off in the evening?

41.Do you get a dip in energy in the afternoon?

42.Relationship status? Children?

Sleep

43.Do you have trouble falling asleep at night?

44.Do you have difficulty waking up in the morning? Do you use an alarm?

45.Do you sleep less than 8 hours a night?

46.Do you wake up once or more during the night? If so what times?
 47.Do you sleep in a room with any light or noise?

48.Do you use any sleep aids such as ear plugs, eye mask or black out curtains?

49.Do you use your mobile phone as your alarm and have it close to your bed?

50. Do you wake up feeling tired?

51.Do you go to bed later than 11pm?

52.Do you get up earlier than 6am?

53.Do you use medications (over the counter or prescription) to help you sleep?

Food Dairy