Training Program Questionnaire

PLEASE NOTE: If you don’t have an answer for some of these questions but the question is “required”, simply just fill in the blank space with “NA” (for no answer) so that the questionnaire won’t throw an error once you try to submit it.

Personal information

Name(required)

Email(required)

Age(required)

Height(required)

Weight(required)

Waist circumference(required)

Hip circumference(required)

Wrist circumference(required)

Shoulder circumference(required)

Health

Do you have any previous or current injuries? If yes, please elaborate.(required)

Have you had any surgeries that interfere with your ability to train? If yes, please elaborate and specify. (required)

Do your shoulders hurt when you do shoulder exercises? If yes, please specify with which exercises you experience pain.(required)

Do your elbows hurt when you do presses? No

Only with chest press

Only with shoulder press

Yes

with shoulder and chest presses

Do your knees hurt when you do squats? If yes, what leg exercises can you do pain free?(required)

Do you have any muscle pains or spasms? If yes, where?(required)

Do you experience cold hands and feet? If yes, when do you usually experience this and how often?(required)

Are you usually colder than most other people and get heat flushes every now and then?(required)

Do you have low blood pressure or feel light headed when you stand up or do squats, deadlift and/or military press?(required)

Lifestyle

How much energy do you have during the day? More than I know what to do with

Enough to be moderately active throughout the day and also get a good training session in

Just enough to get a training session in

Not much at all and my training often suffers

What other sports or activities, if any, are you also currently participating in?(required)

Describe your job. Be specific, for example, how many hours are you on your feet, how many hours in front of a screen, do you work with heavy equipment, etc.(required)

On a scale of 1-10, how stressful is your job?(required)

On a scale of 1-10, how much stress is in your personal life and what type of stress does it involve the most?(required)

When do you usually go to bed and when do you usually wake up? Also, what is the quality of your sleep?(required)

Current training regiment

Describe your current training routine, if any?(required)

What previous training programs or exercises have you tried or are trying? Please provide details about what and when.(required)

Have you ever had or do you currently use any of the following: physical therapy, chiropractic massage, acupuncture, Feldenkrais, rolfing, Alexander technique, other? Please provide specifics.(required)

Have you ever worked with a personal trainer? If so, provide details.(required)

What does a typical week of workouts/daily movement look like for you? Be as specific as possible, including time spent training, nature of training.(required)

Do you do additional cardio, if so, please be as specific as possible.(required)

New Training Program

Describe the workout equipment that is available to you, for example, free weights such as barbells and dumbbells, pull-up bar, squat rack, cable machines, hammer strength machines, swimming pool, bike, jump rope, kettlebells, etc.(required)

Is your main goal muscle size, strength, fat loss or a combination?(required)

If your goal is building muscle, do you want to build general mass, or complete symmetry with all muscles?(required)

Do you want a training program with weights or for calisthenics?(required)

How many times would you like to train per week?(required)

How much time do you have available for each training session?(required)

Do you recover quickly after a workout or do you require a few days for optimal recovery?(required)

At what time of the day would you like to train, or do you feel best to train?(required)

Would you like to progress in the powerlifts? (squat, bench and deadlift)(required)

Do you have any weak points, either strength or specific muscles that you want to improve on?(required)

Would you want to do additional cardio with your weight training/calisthenic program?

Do you enjoy explosive or more slow paced cardio?(required)

Final thoughts

Describe what you truly desire from working with me, Hans. What do you want out of your training/this season/this part of your life? In other words, why are you sitting here, taking valuable minutes out of your life to complete this form? You may also use the following section to include any additional general notes for me. Include anything that you feel would be helpful that you haven’t yet had a chance to express.(required)

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