Questionnaire Page1 / 1 100% of survey complete. Contact details are required fields. Question Title * 1. Contact Details Name Email Address CURRENT GOALS: Question Title * 2. My MAIN health and fitness goals are: NOT TRUE SOMETIMES TRUE MOSTLY TRUE TRUE Fat Loss Fat Loss NOT TRUE Fat Loss SOMETIMES TRUE Fat Loss MOSTLY TRUE Fat Loss TRUE Build Muscle Build Muscle NOT TRUE Build Muscle SOMETIMES TRUE Build Muscle MOSTLY TRUE Build Muscle TRUE Gain Strength Gain Strength NOT TRUE Gain Strength SOMETIMES TRUE Gain Strength MOSTLY TRUE Gain Strength TRUE Aeorbic Fitness Aeorbic Fitness NOT TRUE Aeorbic Fitness SOMETIMES TRUE Aeorbic Fitness MOSTLY TRUE Aeorbic Fitness TRUE Happiness & Feel Better Happiness & Feel Better NOT TRUE Happiness & Feel Better SOMETIMES TRUE Happiness & Feel Better MOSTLY TRUE Happiness & Feel Better TRUE Improve Nutritional Habits Improve Nutritional Habits NOT TRUE Improve Nutritional Habits SOMETIMES TRUE Improve Nutritional Habits MOSTLY TRUE Improve Nutritional Habits TRUE CURRENT TRAINING: Question Title * 3. When I exercise, it consists of: NOT TRUE SOMETIMES TRUE MOSTLY TRUE TRUE Cardio/Aerobic Exercise Cardio/Aerobic Exercise NOT TRUE Cardio/Aerobic Exercise SOMETIMES TRUE Cardio/Aerobic Exercise MOSTLY TRUE Cardio/Aerobic Exercise TRUE Weight/Strength Training Weight/Strength Training NOT TRUE Weight/Strength Training SOMETIMES TRUE Weight/Strength Training MOSTLY TRUE Weight/Strength Training TRUE Body Weight Training Body Weight Training NOT TRUE Body Weight Training SOMETIMES TRUE Body Weight Training MOSTLY TRUE Body Weight Training TRUE Classes Classes NOT TRUE Classes SOMETIMES TRUE Classes MOSTLY TRUE Classes TRUE Sports Specific Sports Specific NOT TRUE Sports Specific SOMETIMES TRUE Sports Specific MOSTLY TRUE Sports Specific TRUE Question Title * 4. I have access to a gym: NOT TRUE SOMETIMES TRUE MOSTLY TRUE TRUE NOT TRUE SOMETIMES TRUE MOSTLY TRUE TRUE Question Title * 5. I have experience in a gym with weight training: NOT TRUE SOMETIMES TRUE MOSTLY TRUE TRUE NOT TRUE SOMETIMES TRUE MOSTLY TRUE TRUE Question Title * 6. I feel confident in a gym and how to correctly use equipment: NOT TRUE SOMETIMES TRUE MOSTLY TRUE TRUE NOT TRUE SOMETIMES TRUE MOSTLY TRUE TRUE PAST EXPERIENCES: Question Title * 7. I find I get bored easily: NOT TRUE SOMETIMES TRUE MOSTLY TRUE TRUE NOT TRUE SOMETIMES TRUE MOSTLY TRUE TRUE Question Title * 8. I am currently following or previously have followed a training plan: NOT TRUE SOMETIMES TRUE MOSTLY TRUE TRUE NOT TRUE SOMETIMES TRUE MOSTLY TRUE TRUE Question Title * 9. I feel I easily become de-railed and loose track: NOT TRUE SOMETIMES TRUE MOSTLY TRUE TRUE NOT TRUE SOMETIMES TRUE MOSTLY TRUE TRUE Question Title * 10. I enjoy training and am excited about going to the gym: NOT TRUE SOMETIMES TRUE MOSTLY TRUE TRUE NOT TRUE SOMETIMES TRUE MOSTLY TRUE TRUE Question Title * 11. I always achieve the goals I set myself: NOT TRUE SOMETIMES TRUE MOSTLY TRUE TRUE NOT TRUE SOMETIMES TRUE MOSTLY TRUE TRUE Question Title * 12. I push myself hard and can train without guidance: NOT TRUE SOMETIMES TRUE MOSTLY TRUE TRUE NOT TRUE SOMETIMES TRUE MOSTLY TRUE TRUE PERSONALITY: Question Title * 13. I manage my stress levels well all of the time and can switch off when needed: NOT TRUE SOMETIMES TRUE MOSTLY TRUE TRUE NOT TRUE SOMETIMES TRUE MOSTLY TRUE TRUE Question Title * 14. I get 6-8 hours of good quality sleep every night without interruptions and wake refreshed: NOT TRUE SOMETIMES TRUE MOSTLY TRUE TRUE NOT TRUE SOMETIMES TRUE MOSTLY TRUE TRUE Question Title * 15. I am passionate about my career/job and enjoy going to work: NOT TRUE SOMETIMES TRUE MOSTLY TRUE TRUE NOT TRUE SOMETIMES TRUE MOSTLY TRUE TRUE Question Title * 16. I am an energised, happy and motivated individual: NOT TRUE SOMETIMES TRUE MOSTLY TRUE TRUE NOT TRUE SOMETIMES TRUE MOSTLY TRUE TRUE Question Title * 17. I struggle with my moods, feel flat and suffer from anxiety: NOT TRUE SOMETIMES TRUE MOSTLY TRUE TRUE NOT TRUE SOMETIMES TRUE MOSTLY TRUE TRUE Question Title * 18. My fitness level is great: NOT TRUE SOMETIMES TRUE MOSTLY TRUE TRUE NOT TRUE SOMETIMES TRUE MOSTLY TRUE TRUE NUTRITION: Question Title * 19. How many meals and snacks do I eat each day? NOT TRUE SOMETIMES TRUE MOSTLY TRUE TRUE 1-2 1-2 NOT TRUE 1-2 SOMETIMES TRUE 1-2 MOSTLY TRUE 1-2 TRUE 3-4 3-4 NOT TRUE 3-4 SOMETIMES TRUE 3-4 MOSTLY TRUE 3-4 TRUE 5-6 5-6 NOT TRUE 5-6 SOMETIMES TRUE 5-6 MOSTLY TRUE 5-6 TRUE Question Title * 20. I am currently following a diet, meal plan or meal prep service: NOT TRUE SOMETIMES TRUE MOSTLY TRUE TRUE NOT TRUE SOMETIMES TRUE MOSTLY TRUE TRUE Question Title * 21. I have a good understanding of calories and macronutrients and how to implement them into my own lifestyle: NOT TRUE SOMETIMES TRUE MOSTLY TRUE TRUE NOT TRUE SOMETIMES TRUE MOSTLY TRUE TRUE Question Title * 22. Dietary restrictions or choices NOT TRUE SOMETIMES TRUE MOSTLY TRUE TRUE Vegetarian Vegetarian NOT TRUE Vegetarian SOMETIMES TRUE Vegetarian MOSTLY TRUE Vegetarian TRUE Vegan Vegan NOT TRUE Vegan SOMETIMES TRUE Vegan MOSTLY TRUE Vegan TRUE Pescetarian Pescetarian NOT TRUE Pescetarian SOMETIMES TRUE Pescetarian MOSTLY TRUE Pescetarian TRUE Gluten Intolerant or Choose to avoid Gluten Gluten Intolerant or Choose to avoid Gluten NOT TRUE Gluten Intolerant or Choose to avoid Gluten SOMETIMES TRUE Gluten Intolerant or Choose to avoid Gluten MOSTLY TRUE Gluten Intolerant or Choose to avoid Gluten TRUE Lactose Intolerant or Choose to avoid Lactose Lactose Intolerant or Choose to avoid Lactose NOT TRUE Lactose Intolerant or Choose to avoid Lactose SOMETIMES TRUE Lactose Intolerant or Choose to avoid Lactose MOSTLY TRUE Lactose Intolerant or Choose to avoid Lactose TRUE Question Title * 23. I get daily cravings and succumb to them: NOT TRUE SOMETIMES TRUE MOSTLY TRUE TRUE NOT TRUE SOMETIMES TRUE MOSTLY TRUE TRUE Question Title * 24. I drink alcohol and on average would consume weekly: NOT TRUE SOMETIMES TRUE MOSTLY TRUE TRUE 0 standard drinks per week 0 standard drinks per week NOT TRUE 0 standard drinks per week SOMETIMES TRUE 0 standard drinks per week MOSTLY TRUE 0 standard drinks per week TRUE 1-5 standard drinks per week 1-5 standard drinks per week NOT TRUE 1-5 standard drinks per week SOMETIMES TRUE 1-5 standard drinks per week MOSTLY TRUE 1-5 standard drinks per week TRUE 6-10 standard drinks per week 6-10 standard drinks per week NOT TRUE 6-10 standard drinks per week SOMETIMES TRUE 6-10 standard drinks per week MOSTLY TRUE 6-10 standard drinks per week TRUE 10+ standard drinks per week 10+ standard drinks per week NOT TRUE 10+ standard drinks per week SOMETIMES TRUE 10+ standard drinks per week MOSTLY TRUE 10+ standard drinks per week TRUE Question Title * 25. My digestion is good and regular (no suffering from discomfort, constipation, bloating, gas, diarrhoea, heart burn, burping): NOT TRUE SOMETIMES TRUE MOSTLY TRUE TRUE NOT TRUE SOMETIMES TRUE MOSTLY TRUE TRUE MOTIVATION: Question Title * 26. I am open minded, motivated and willing to do what it takes to optimise my health and fitness: NOT TRUE SOMETIMES TRUE MOSTLY TRUE TRUE NOT TRUE SOMETIMES TRUE MOSTLY TRUE TRUE Question Title * 27. I am confused, de-motivated and feel like I've tried everything before: NOT TRUE SOMETIMES TRUE MOSTLY TRUE TRUE NOT TRUE SOMETIMES TRUE MOSTLY TRUE TRUE Question Title * 28. I've achieved my goals before, but always slip back into old habits: NOT TRUE SOMETIMES TRUE MOSTLY TRUE TRUE NOT TRUE SOMETIMES TRUE MOSTLY TRUE TRUE Thank you for completing our Questionnaire. Jewel Athletic recommend reviewing and assessing your results to see where your weaknesses and downfalls lie. Being aware of personal strengths and weaknesses is important for continual progression.Need assistance planning your next goal or adhering to a plan? Email us today! Submit
