Initial evaluation

Initial evaluation for personal training

Initial evaluation for personal training

Welcome! I am so excited and honor to become your trainer and coach.

Please answer the following questions. This questionnaire covers key questions on nutrition, movement, stress, and sleep. Completing this form will allow me to get to know more about which skills are going to be most relevant for you. Those are the skills that will get you (personally) the most traction towards your goals.

Many of the questions ask you to reflect on specifics of who you are, what you're experiencing right now, and what you want.

Take time with it. Think it through. Be honest!

These questions are critical information for you to know.

The more you know about you, the easier you can express those wants and needs to your coach.

The more your coach knows about you, the better they can personalize your coaching program and, the more personalized your program, the better your results.

Please let me know if you have any question, talk you you soon!



What drives you? In ~1-2 short sentences, write a personal statement on why your goal is important to you. For example, if your goal is to Lose Weight and you have a specific weight in mind, why is that number important for your lifestyle? This is the Why that drives your coaching program. It will likely continue to develop along the way. (Every answer is a good answer.)
1: not at all / 5: moderately / 10: totally
1: not at all / 5: moderately / 10: totally
Are you exercising regularly? *

Exercise and Movement

Do you have any existing injuries or conditions that I should be aware of while building your training plan?
If you have more than one area of restriction, please choose the option that requires the greatest modifications to your workout program. Let your coach know more of the specifics of the pain / discomfort that you feel related to movement and exercise.
Which of these best describes the lower limb pain / discomfort that you're experiencing?
How would you describe the severity of your lower limb pain?
Which of these best describes the back pain / discomfort that you're experiencing?
How would you describe the severity of your back pain?
Which of these best describes the upper limb pain / discomfort that you're experiencing?
How would you describe the severity of your upper limb pain?
Other than exercises, what else would you most like to work on to support your goals?

Pelvic Floor Screening

This part to help identify if you may be at risk of pelvic floor dysfunction and allow me to safely plan your exercises.
Are you currently pregnant?
Have you recently (or ever) had a baby?
Are you going through or have been through menopause?
Have you ever undergone gynecological surgery (e.g., a hysterectomy)?
Are you an elite athlete (e.g., a runner, gymnast, or trampolinist)?
Do you have a history of lower back pain?
Have you ever injured your pelvic region (e.g., through a fall or pelvic radiotherapy)?
Do you experience constipation or regularly strain on the toilet?
Do you have a chronic cough or sneeze (e.g., because of asthma, smoking, or hayfever)?
Do you have a BMI over 25?
Do you frequently lift heavy weight (e.g., at work or at the gym)?
Accidentally leak urine when you exercise, play sports, laugh, cough or sneeze?
Need to get to the toilet in a hurry, and do you sometimes not make it there in time?
Constantly need to go to the toilet?
Find it difficult to empty your bladder or bowel?
Accidentally lose control of your bowel, or accidentally pass wind?
Have a prolapse (e.g., a bulge or feeling of heaviness, discomfort, pulling, dragging, or dropping in the vagina)?
Experience pelvic pain or pain during or after sex that involves vaginal penetration?