Client Questionnaire Form

North Star Zenergy
Client Questionnaire Form

Below is a detailed questionnaire designed to go in depth of who you are regarding habits with fitness and nutrition. It's extremely important to fill out the questionnaire with as detailed responses as possible to ensure the optimal efficiency of your exercise and nutrition program.

Full Name

Phone Number

Current weight/height/age

Sex or Gender

Ethnicity

Current City & State/Country of Residence

Current Occupation/Day Job

What does your work schedule look like?

Do you run any other business on the side?

Instagram Handle

What is your #1 fitness/bodybuilding related goal that you wish to accomplish by next year? Please be as detailed as possible..

What do you struggle with the most when attempting to reach this goal?

In the next 3 months I would like to focus on...

What body parts/muscle groups do you want to bring up the most?

How many training days of the week are you able to fit into your schedule? BE REALISTIC; Fitness is a lifestyle change.

What body parts/muscle groups are your strengths?

Past or current injuries/limitations:

What does your current workout routine look like?

Do you count your macros? If no, is this something you're open minded to?

Is this a strict meal plan or is it IIFYM (if it fits your macros)?

What does your current diet look like?

What vices do you have with food? - BE HONEST even if they are minimal to your mental health (fast food addiction, binge eating, etc.)

How many meals per day are you currently eating?

How many meals can you realistically fit into your days? Are you able to add in more meals on off-work days?

What is your monthly budget for food/supplements?

What foods do you LOVE to eat?

What foods do you HATE to eat?

How much time per week can you dedicate to meal prepping?

List allergies:

Are you currently on any form of testosterone replacement therapy or other hormones?

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North Star Zenergy Client Questionnaire Form

This site is not a part of the Facebook website or Facebook Inc. Additionally, This site is NOT endorsed by Facebook in any way. FACEBOOK is a trademark of FACEBOOK, Inc.

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North Star Zenergy
Client Questionnaire Form