BadDad Barbell Client Questionnaire

Full Name

First NameLast Name

Email

example@example.com

Gender

Date of Birth

MonthDayYear

Age

years

Height

In

Weight

Lb

What are your current 1 rep or 3 rep maxes? If you don’t currently know that’s ok too

What equipment do you have available in your gym?

What are you current training goals?

What do you do for a living?

Whats the activity level at your job?

Do you follow a regular working schedule, do you work days, afternoon or nights?

How often do you travel?

Please list the physical activities that you participate in outside of the gym and outside of work.:

If you have any diagnosed health problems list the condition(s).

If you are on any medications, please list them.

What additional therapies are being undertaken for the given health problem(s)?

If you have any injuries, please list them.

What additional therapies are being undertaken for the given injury?

Are you experiencing any stresses or motivational problems?

Has anyone of your immediate family developed heart disease before the age of 60?

Do any diseases run in your family?

Do you suffer from diabetes, asthma, high or low blood pressure?

if yes please list:

Your current diet could be best characterized as:

Please rate your physical activity level outside of the gym from 1.3(sedentary)-1.7(heavily active all the time)

What following goals does best fit in with your goals?

What is your goal with your training?

Why?

How often are you willing to train a week to reach your goal?

Are you currently excersising regulary (at least 3x per week)?

Have you ever had a coach for training before?

If yes what kind of training did you do:

At what times during the day would you prefer to train?

How often do you want to train a week?

Please Choose

•Check-ins are to be done via Instagram DM's sent to @dadbod220 to avoid getting lost in personal message clutter. I only require two videos per training session(one of top set, and one of clients choice)

•Please ensure all videos are trimmed and edited

•Feel free to ask questions, but also use YouTube/Google/Social Media to look for responses to simple questions

•Let me know if something regularly hurts(we can work around it)

How should I get in contact with you in reply to this form?