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[ Please Select ] Beginner
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What
is your primary fitness goal?
[ Please Select ] Lose
fat (weight loss) Build lean
muscle (bulk up) Both
(drop fat/build lean muscle)
What
is the biggest problem area on your body?
[ Please Select ] Hips/Thighs
Butt Stomach/Love
Handles
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Weight Training
Information
What
type of weight training do you do?
[ Please Select ] Free
Weights Machines Both
I Don't Weight Train
How
many days per week do you weight train?
[ Please Select ] 1-2
Times/Week 3-4 Times/Week 5-6
Times/Week Everyday I
Don't Weight Train
What
is your average rep/set range?
[ Please Select ] High
Reps/High Sets High Reps/Low Sets
Low Reps/High Sets Low
Reps/Low Sets Med Reps/Med Sets
I Don't Weight Train
Do
you train each set to positive failure?
[ Please Select ] Yes No
I Don't Weight Train
What
time of day do you weight train?
[ Please Select ] Morning
Afternoon Evening
I Don't Weight Train
What
supplements do you take before training?
What
supplements do you take after training?
Do
you change exercises between sessions?
[ Please Select ] Yes No
I Don't Weight Train
How
many days of rest between muscles groups?
[ Please Select ] 1-2 Days
3-4 Days 5-6 Days
Over 6 Days I
Don't Weight Train
Do
you keep a journal of your training sessions?
[ Please Select ] Yes No
Cardiovascular
Information
What
is your primary type of cardio training?
[ Please Select ] Running/Jogging
Elliptical Trainer Stair
Climber Cycling Aerobics
Jumping Rope Sprinting
Swimming Walking
I Don't Do Cardio
How
many days per week do you cardio?
[ Please Select ] 1-2
Times/Week 3-4 Times/Week 5-6
Times/Week Everyday I
Don't Do Cardio
How
long is each cardio session?
[ Please Select ] 15 Minutes
30 Minutes 45 Minutes
1 Hour Over 1
Hour I Don't Do Cardio
What
is your cardio training intensity level?
[ Please Select ] Slow
& Steady Moderate Intense
I Don't Do Cardio
What
time of day do you do your cardio training?
[ Please Select ] Morning
Afternoon Evening
I Don't Do Cardio
What
supplements do you take before cardio?
What
supplements do you take after cardio?
Do
you change exercises between sessions?
[ Please Select ] Yes No
I Don't Do Cardio
How
many days of rest between cardio sessions?
[ Please Select ] 0 Days
1-2 Days 3-4 Days
5-6 Days Over 6
Days I Don't Do Cardio
Do
you keep a journal of your cardio sessions?
[ Please Select ] Yes No
Diet/Nutrition
Information
What
type of diet are you currently on?
[ Please Select ] Atkins
The Zone South Beach
Dr. Phil Jenny Craig
Weight Watchers Vegetarian
Basic Low Calorie I'm
not on one
How
many meals do you eat per day?
[ Please Select ] 1-2
Meals/Day 3-4 Meals/Day 5-6
Meals/Day Over 6 Meals
Do
you eat breakfast?
[ Please
Select ] Yes No
What
size are your average meals?
[ Please Select ] Small
Medium Large
Do
you tend to snack during the day?
[ Please Select ] Yes No
What
is your most common cheat food?
[ Please Select ] Candy
Cake Pie Donuts
Ice Cream Pizza
Hamburgers Pizza
Hot Dogs
How
often do you eat fast food?
[ Please Select ] Never
1-2 Times/Week 3-4
Times/Week 5-6 Times/Week Everyday
Do
you tend to binge when you cheat on your diet?
[ Please Select ] Yes No
Do
you tend to eat cheat foods late at night?
[ Please Select ] Yes No
Do
you keep a journal of your dietary intake?
[ Please Select ] Yes No
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