Name *

First Name

Last Name

Gender *

Male

Female

Other

How long have you been training? (Include gym, sports or any other focused physical activity) *

Never

Just starting out

1-6 months

6-12 months

1-3 years

4-5+ years

What are your pefered training times? *

Early morning

Morning

Afternoon

Evening

Which of these best describes your current day to day activity level? *

Sedentary (Little to no exercise)

Light activity (Light exercise 1-2 days/week)

Moderate activity (Moderate exercise 3-5 days/week or an active job)

High activity (Hard exercise 6-7 days/week or a very physically demanding job)

Which of these most closely describes your current diet: *

Mostly whole foods

Mostly processed foods

A varried mix of both of the above

How confident do you feel when it comes to managing your nutrition and how it relates to your lifestyle and training?

Very confident

Have some idea, but unsure on many things

Not very confident

What type of learner are you? (this will help with how I communciate and deliver support to you, feel free to select as many as you feel applies to you) *

Visual

Auditory/Listening

Reading & writing

Kinesthetic (hands on, physically doing)

Has your doctor ever said you have a heart condition and that you should only do physical activity recommended by a doctor? *

Yes

No

Do you feel pain in your chest when you do physical activity? *

Yes

No

In the past month, have you had chest pain when you were not doing physical activity? *

Yes

No

Do you lose balance because of dizziness or do you ever lose consciousness? *

Yes

No

Do you have a bone or joint problem ( for example back, knee or hip) that could be made worse by a change in your physical activity? *

Yes

No

Is your doctor currently prescribing medication for your blood pressure or heart condition? *

Yes

No

Do you know of any other reason why you should not take part in physical activity? *

Yes

No

Have you read and agree to the promise document? *

Yes

Do you understand that as a client of ATF, elements of you're progress and feedback to the service may be shared on social media for promotional purposes? *

Yes