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1 on 1 Goal Consultation

1 on 1 Consultation

Thank you SO much for taking the time to have a 1 on 1 consultation with one of our goal specialists! Please take the time to read through the questions carefully.

We understand that some of the questions may be sensitive topics however we encourage you to be as honest as possible as the more info we have the more equipped we will be to make sound recommendations toward your personal goals and needs during our discussion. Once we receive and read through your responses we will organize your consultation time!
1.First / Surname,  Email Address & Mobile Number(Required.)
2.What is your age?
3.Do you currently have any diagnosed medical conditions such as; Coeliac disease, Heart Condition, High blood pressure, Other?
4.List any current medication you take.
5.Are you pregnant or breastfeeding, or trying to conceive?
6.Do you have any allergies, intolerances or sensitivities?
7.What is your Height & Weight?
8.What is your sex?
9.What Are Your Main Goals? (Check up to 3 Goals)
10.Do you have any specific problem areas you wish to lose fat from/target?
11.What is your Job Description? (Eg. Stay at Home Parent, Office Worker etc.)
12.What is your average daily activity level? (ie. The movement you do from morning to sleeping, excluding training and planned cardio.)
Sedentry
Lightly Active
Very Active
13.Do you have any relevant health/medical conditions or concerns? If yes, please complete below.
14.List any supplements you take.
15.Do you experience any symptoms of poor gut health? (eg. Bloating, Constipation, Diarrhea etc) 
16.On a scale of 1-10 how healthy do you believe your diet to be?
1 (Extremely Unhealthy)
Normal
10 (Extremely Healthy)
17.Do you experience cravings for certain foods? (eg. Chocolate, Lollies, Pasta etc)
18.Do you have any dietary restrictions?
19.How often per week do you exercise?
20.What is the duration of a normal exercise session for you?
21.How intense is your exercise?
1 (Light eg. Walking)
10 (Very Intense eg. F45 / Crossfit)
22.Where abouts do you currently exercise? 
23.How many litres of water do you drink per day?
24.How many coffees or energy drinks do you drink per day?
25.Rate your energy levels during the day
Low
Medium
High
Morning (On Waking)
Midday
Afternoon
Evening
26.Do you experience any problems sleeping?