Sunday, 01 August 2010
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Fitness 15
Super Body Questionnaire
Please fill out the questionaire as best you can!
Name
Age
Gender
F
emale
M
ale
Address
Home phone
Mobile
email
Occupation
Height
Weight
How much weight do you think you need to lose?
What is your goal?
Do you have a target date to reach?
Your typical work schedule: eg. Start time, lunch break, other breaks.
Do you currently work-out?
N
o
Y
es
Your typical workout schedule (if any):ie. weights and cardio sessions / days per week
What parts of your body would you like to improve or work on?
When do you normally weight train?
When do you do cardio?
Your typical diet for one day and the times you normally eat.
Do you currently take supplements?
Y
es
N
o
What do they include?
Do you have cravings? And what time do you have them?
Do have any health problems? diabetes, heart condition, physical disabilities.
Anything else?
Attach current photo (in shorts and singlet please) optional
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