AT HOME QUESTIONNAIRE

AT-HOME PROGRAM QUESTIONNAIRE

Name

Phone Number

How many different weekly workout routines do you want (1-3)? You'll receive a new set of routines every 2 weeks

What equipment do you have available to you? (dumbbells, resistance cords, jump rope, cones, TRX, kettlebells, booty bands)

What injuries/limitations do you have?

On a scale of 1-5, how would you grade your current fitness level? (1- inexperienced, 3- average, 5- great shape)

On a scale of 0-3, how much UPPER BODY exercise do you want included in your program? (0- none at all, 3- area of importance)

What upper body muscles are most important to you? (shoulders, chest, biceps, triceps, back, balance of everything)

On a scale of 0-3, how much LOWER BODY exercise do you want included in your program?

What lower body muscles are most important to you? (glutes, hamstrings, quads, hips, balance of everything)

On a scale of 0-3, how much CORE/ABS exercise do you want included in your program?

On a scale of 0-3, how much CARDIO exercise do you want included in your program?

Any other goals and/or specific exercises you'd like us to include?

Would you be interested in adding online private coaching sessions ($30/session)?

Any additional comments, questions?