Tell Us About Yourself

Please fill out the following forms, it will help us better understand who you are, who you want to be, and which Grow Your Muscles Studio team member will be able to help get you there in a way that best works for you.

General Questionnaire

Subject

Name

First Name

Last Name

Email Address

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Age

What is your Occupation?

Understanding your lifestyle will help optimize your programming.

Height

Weight

As of this morning

Measurements

Please provide your body measurement, it will help us address a plethora of issues. Measure your waist, buttocks/hips, middle of both thighs, belly button, biceps, and neck.

Body Fat Storage

Is there a part of your body that you feel collect more fat than others?

Core Goals

Rank the following from 1 (highest) to 5 (lowest). Increased Strength Increased Muscle Mass Fat Loss Improved Energy Other

Specific Goals

Do you have any specific goals you'd like to work on?

Ideal or Goal Weight

Do you have an Ideal or Goal Weight?

Exercise Regularity

Are you exercising regularly? How often are you willing to exercise in a week?

Exercise History

Have you ever used a formal fitness program in the past? How did it go? What did you enjoy about the program? How could that program be improved to suit your needs?

Typical Workout

Please give an example of what a typical workout/activity week might look like. Include duration along with activity.

Cardio

What type of cardio do you do?

Injuries

Do you have any injuries? If so, please describe.

Health Issues

Do you have any other health issues? I.e. asthma, cancer, diabetes, depression, anxiety, sleeping disorders, eating disorders? If so, please describe.

Preferred Workouts

Do you have prefer workouts or exercises?

Training Locations

Do you train in a gym or at home? Do you have any equipment restrictions?

Food Allergies

Do you have any known food allergies or sensitivities? If yes, please explain.

Alcohol Consumption

Do you drink alcohol, if so how many beverages do you average per week?

Supplements

Are you using any nutritional supplements are the moment? If yes, please list them – including the brand and the amounts that are taken.

Daily Meals Consumed

How many meals do you consumer per day?

Past Efforts

When was the last time you tried to shift your efforts at food or change aspects of your lifestyle to be healthier?

Food Preferences

Are there any foods you will not eat?

Food Snapshot

Please provide a snapshot of your current food and beverages choices in the last 24 hours – breakfast, lunch, dinner, snacks, and all beverages including water.

Other Information

Is there any other information you think relevant to your program design which might affect your safety, your enjoyment of the program, or the level of relative challenge? Do you enjoy being pushed or is working out something you hate doing?

Social Media Testimonials

Are you okay with sharing your progress pictures and testimonials on the Grow Your Muscles Studio social media sites platforms? (You would maintain right of refusal and final say on published content)

Health Questionnaire

For the majority of people physical activity should not present any issues. This is to identify the minor number of adults for whom physical activity might be inappropriate or those who should have medical advice regarding the type of activity most suitable for them.

Subject

Name

First Name

Last Name

Heart Health

Has your doctor ever said you have heart trouble?

Chest Pain

Do you have pains in your heart and chest?

Blood Pressure

Has a doctor ever said your blood pressure was too high?

Joint Problems

Has your doctor ever told you that you have bone or joint problems such as arthritis that has been aggravated by exercise, or might be made worse with exercise?

Other Concerns

Are there any other physical reasons not mentioned here why you should not follow an activity program even if you wanted to?

If you answered YES to one or more questions…

If you have not recently done so, consult with your personal physician by telephone or in person before increasing your physical activity.

If you answered NO to all the questions…

If you answered this accurately, you have reasonable assurance of your present suitability for physical activity.