PRE-EXERCISE QUESTIONNAIRE

To apply to Become a Wedgette, please fill out the form below…

YOUR DETAILS

First Name*

Last Name*

Address*

City*

Postcode*

Country*

Phone*

Email*

DOB*

 

TRAINING

Do you have any experience in resistance training or sports?*
YesNo

If yes, explain what type, how long you have done it for, and how often you do it.

What is your main goal?*

Why is it important that you achieve your goal?*

What do you hope to achieve from your Wedges & Weights personal coaching?*
Fat LossMuscle GainImprove StrengthBetter BalanceImprove MindsetImprove NutritionBoost Body ConfidenceStress ManagementAerobic EnduranceFlexibilitySport SpecificOther

 

Do you have any other specific goals? (exercises, body parts)*

How many times per week do you want to commit to training with Wedges & Weights?*

Where will you be training?*
At HomeIn Gym

If at home, do you have any equipment? If so, please list.

Will you be doing any other sort of training? If so, how often?*

When do you hope to achieve your goal by?*

On a scale of 1 to 10, how intense do you like your training sessions to be (10 being the most intense)?*

What time of day is best for your 121 online mentor sessions (Mon-Fri)*

I only take on a small number of wedgettes per month in order to give you the support you need to achieve your goal.

Tell me what makes you an ideal candidate to become a wedgette and why I should coach you?*

NUTRITION

How would you describe your current nutrition?*

What guidance do you need the most?*

Do you have/are you willing to find the time to prepare your food?*
YesNo

BODY IMAGE

How do you currently feel about yourself and why?*

How do you want to feel about yourself and why?*

HEALTH

Do you/have you suffered any injuries or illnesses that may affect your training?*
No History of Injuries or IllnessesHeart ConditionChest PainFainting/DizzinessJoint PainsHigh/Low Blood PressureArthritisAsthmaDiabetesEpilepsyRegular HeadachesBack PainHigh CholesterolA HerniaMuscular Pains or CrampsAny InfectionsFamily History of Heart Disease/StrokeAny Major InjuriesOther

If you ticked any injuries or other, please explain

Are you pregnant, planning to become pregnant, or given birth within the past 8 weeks?*
YesNo

If you have ticked yes to any of the above conditions, have you been given clearance by your doctor to exercise?

Please tick this box to confirm that you have answered all of the questions in this pre-exercise questionnaire honestly and to the best of your knowledge*

I confirm I have fully read and understood the Terms of Service*

I consent to having Wedges & Weights collect my name, email and personal details given above, and give my consent for Wedges & Weights to contact me via email, phone and/or mailing address. I consent to be added to the Wedges & Weights mailing list where your first name, last name and email address is stored with Mailchimp for the sole purpose of sending you emails containing tips, workouts, offers and news. You can unsubscribe at any time by clicking 'unsubscribe from this list' at the bottom of each email. Please read my Privacy Policy for more information.*

Date*