Welcome to your consultation questionnaire!
Your responses are going to allow me to give you as great and as comprehensive a service as possible, so answer in as much detail as you can.
Let's go
 
Name

 
Age

 
Gender


 
Current bodyweight in kg

 
Has your doctor ever said you have a heart condition and that you should only do physical activity as recommended by a doctor?

     
 
Do you feel pain in your chest when you do physical activity?

     
 
In the past month, have you had a chest pain when you were not doing physical activity?

     
 
Do you lose balance because of dizziness or do you ever lose consciousness?

     
 
Do you have a bone or joint problem (for example, back, knee or hip) that could be made worse by a change in your physical activity?

     
 
Is your doctor currently prescribing medication for your blood pressure or heart condition?

     
 
Do you know of any other reason why you should not do physical activity?

     
 
If you answered yes to any of the above, have you consulted with your doctor to clarify it's safe for you to become physically active and in your current state of health?

If you answered no to all the previous questions, by selecting "yes" you confirm that it is safe for you to participate in physical activity.

     
 
The information I will give you on the program is for educational purposes only and does not replace the advice of a qualified medical profession, nor does any information or guidance I ever give you qualify as a means to prevent or treat any disease. Do you accept these terms?

     
 
What are your goals? Please write in as much detail as possible, giving time frames if applicable.

 
Do you have any health issues that affect your diet? If so have you ever been told by a health professional to avoid certain foods?

 
On average, how much sleep do you get per night? Do you feel rested upon waking?

 
Do you currently follow any approach to your diet? If yes please outline below. If no please give a typical day's worth of food below.

 
What are your favourite foods and drinks? These can be "healthy" or "unhealthy"... there's no right or wrong here!!

 
What foods or drinks do you dislike?

 
Do you currently follow a training program? If so please outline in as much detail as possible. If you have it as a document you can forward it to james@jamesblanchard.co.uk

 
Do you have any questions for me, or anything you think I've missed that should be considered in the design of your program?

 
Before & after pictures are a great motivator and a useful tool for us both to check progress. Please send a whole body picture from a front, back and side view in as little clothing as you are comfortable with to james@jamesblanchard.co.uk

 
Finally, have you ever worked with an online coach before? If so, what experiences did you have?

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