Website Members
Below are visitors who have created an online account.
Click 'SYSTEM CHECK' to see if they have completed any forms and if you have written any fitness plans.
Click 'Plan' to view/write fitness plans and check any completed sessions.
Click 'Progress' to monitor any fitness updates your client has recorded.
number of site members
Lifestyle Questionnaire
Occupation:
Chemical engineer
Daily hours at a computer
Active on a daily basis (1-10, 10 is being highly active)
L
Consistently active for how long
Daily sleeping hours
L
Ergonomic desk/workstation?
Daily hours seated?
Weekly exercise
Interested activities
Football
Anything else not listed
L
Stressed
Smoker
no
Alcohol
no
On a diet?
Details if yes
Number of cigarettes
Amount of units, if yes
Details, if yes
Feel about nutrition
Approx Daily Consumption
Coffee
1
Glasses of water
1
Sweets
Tea
1
Fruit/veg
Chocolate
Soda/coke
1
Bread/pasta
Glasses of Milk
1
Sugar
Food Snapshot
Breakfast
Q
Lunch
Q
Dinner
1
Snacks
1
Please list THREE goals, in order of importance...
Goal 1
Q
Goal 2
Close to goal 1
W
Close to goal 2
S
Goal 2
Z
Close to goal 3
S
What is the biggest challenge you must overcome to attain your goal?
Biggest challenge to Goal
Biggest challenge: other
Commitment level (1-10, 10 being highly committed)
List three tasks you can do to pave the path towards total achievement.
Task 1
Task 2
Task 3
Personal Trainer before
PT details if yes
Find out about me?
Leaflet
Why me?
Physical Activity Readiness Questionnaire (PAR-Q)
Doctor ever said client has a heart condition and they should only do physical activity recommended by a doctor?
yes
Ever feel chest pain when physically active?
no
Chest pain in the past MONTH when physically active?
yes
Lose balance, or consciousness, or get dizzy?
yes
Joint or back problems that could be made worse by a change in physical activity?
no
Doctor prescribed medication for blood pressure or heart conditions?
yes
Any other reason you should not do physical activity?
yes
Extra comments
Ticked to confirm understood and agreed
true
Original Date of submission:
8 February 2024 at 21:31:54
'We are what we repeatedly do. Excellence, then, is not an act but a habit' - ARISTOTLE
