What is your fitness goal?
Mark the picture that describes the best your body composition

Health Related Questions

Has your doctor ever said that you have a heart condition OR high blood pressure?
Do you feel pain in your chest?
Do you lose balance?

(Please answer NO if your dizziness was associated with over-breathing (including during vigorous exercise)

Have you ever been diagnosed with another chronic medical condition (other than heart disease or high blood pressure)?
Are you currently taking prescribed medications for a chronic medical condition?
Do you currently have (or have had within the past 12 months) a bone, joint, or soft tissue (muscle, ligament, or tendon) problem that could be made worse by becoming more physically active? Please answer NO if you had a problem in the past, but it does not limit your current ability to be physically active.
Has your doctor ever said that you should only do medically supervised physical activity?
Are you pregnant?
Or have given birth within the last 6 months?
Do you take any medications, either prescription or non-prescription, on a regular basis?
Muscular skeletal Issues
If Back/Spine
Do you have an active diagnosis of an eating disorder (e.g. bulimia, anorexia or similar diagnosis)
How would you describe your relationship with food?

Lifestyle Related Questions

Describe your job
Is your job shift related?
Were you overweight as a child?

Sleeping Related Questions

When you wake up you feel..
Do you usually need sleeping medication?
Have you ever had any advice or treatment for your sleep?
Do you have difficulties exercising or participating in a sporting activity because you are too sleepy or tired?

Fitness History

Have you been exercising consistently for the past 3 months?

Physical Activity And Exercise Related Questions

Skip to next section if you are presently inactive.

In the last year how often have you participated in exercise?
If your participation is lower than you would like it to be, what are the reasons?
Are you currently involved in regular exercise?

Cardio &/or Sports


Strength Training



Nutrition Related Questions

Do you skip meals?
Do you eat breakfast?
Do you eat late at night?
Do you feel drops in your energy levels throughout the day?
Do you know how many calories you eat per day?
52. Are you currently or have you ever taken a multivitamin or any other food supplements?
Do you do your own cooking?
Do you eat foods high in fat and sugar?

Goals Setting

How can a fitness program help you? Please check that which applies.
What are your major goals / targets?
Are there any body parts in particular that you wish to train?
How would you describe your current knowledge of exercise and fitness training?
What is your main reason for wanting to start &Body program?