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PERSONAL DETAILS
Full Name
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Email
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Phone
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What's your age?
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Age
18-25
26-35
36-45
46-55
56-65
66+
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Occupation
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HEALTH / FITNESS EVALUATION
I am happy with my current health, fitness and body
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Your rating (1-5)
1 - Strongly Disagree
2 - Disagree
3 - Neutral
4 - Agree
5 - Strongly Agree
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I have good mobility and can go about my day and my gym sessions pain free
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Your rating (1-5)
1- Strongly Disagree
2 - Disagree
3 - Neutral
4 - Agree
5 - Strongly Agree
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I have a good knowledge on nutrition and follow a flexible nutritional strategy tailored to my body and goals
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Your rating (1-5)
1 - Strongly Disagree
2 - Disagree
3 - Neutral
4 - Agree
5 - Strongly Agree
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I feel comfortable in my clothes and I’m proud of what I see in the mirror
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Your rating (1-5)
1 - Strongly Disagree
2 - Disagree
3 - Neutral
4 - Agree
5 - Strongly Agree
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I have good knowledge on training and I am confident with my program in the gym
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Your rating (1-5)
1 - Strongly Disagree
2 - Disagree
3 - Neutral
4 - Agree
5 - Strongly Agree
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I feel mentally resilient and I’m confident in my abilities to hit my health and fitness goals
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Your rating (1-5)
1 - Strongly Disagree
2 - Disagree
3 - Neutral
4 - Agree
5 - Strongly Agree
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I am ready to invest financially, emotionally and physically into my health & fitness journey
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Your rating (1-5)
1- Strongly Disagree
2 - Disagree
3 - Neutral
4 - Agree
5 - Strongly Agree
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