Online Coaching Questionnaire

Name *

First Name

Last Name

Phone *

(###)

###

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On a scale of 1-5, how would you consider yourself when it comes to fitness? *

Fitness Experience

1 (beginner)

2

3

4

5 (professional)

What is your current activity level? *

Sedentary (office job)

Light Exercise (1-2 days per week)

Moderate Exercise (3-5 days per week)

Heavy Exercise (6-7 days per week)

Athlete (2 times per day)

When it comes to pursuing a healthy lifestyle, what do you struggle with mostly? (Choose one or more)

Nutrition

Exercise

Consistency

On a scale of 1-5, how stressful is your typical day? (5 being the most stressed) *

Stress level

1

2

3

4

5

Do you get bored with things easily? *

Yes

No

Somewhat