HD Consulting | Questionnaire for Personal Training

Name:

Birthday

Email:

Phone:

Address

What's your goal?

Resting heart rate

Height

Weight

Body fat % (If you know)

MEASUREMENTS:

Neck

Middle bicep

Abs (belly button level)

Hips

Bust

Thigh

Calf

What you are currently doing? Detail on - (Diet, cardio, weight training, supplements)

YOUR TOP 5 LIKES FOR CLEAN:

Carbs

Proteins

Fats

Veggies

Fruits

Foods you hate?

Restrictions or injuries?

Allergies?

Pictures; (front, side & back) please send in good lighting & same spot every other week. You can wear suit/sports bra/shorts

Picture: Front

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Picture: Side

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Picture: Back

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METOBOLIC TYPING

Don’t overthink them just whatever comes to your mind first, there isn't a right or wrong. It will help me understand what foods work best for you!

When I feel low I pick right up if I eat something sweet such as fruit pastry or candy and this feeling lasts?

Always

Sometimes

Never

I could enjoy eating potatoes in some form two or three times a day

Always

Sometimes

Never

I could eat red meat daily and often more than once a day

Always

Sometimes

Never

Salads and Raw vegetables agree with me and I eat them often

Always

Sometimes

Never

I prefer fatty cuts of meat (ribs prime rib pork roast) over lean cuts of meat

Always

Sometimes

Never

I may drag through the day but a good meat dinner will snap me out of it

Always

Sometimes

Never

If I don't feel hungry and I eat something sweet my appetite seems to pick up

Always

Sometimes

Never

Steak for breakfast sounds good to me

Always

Sometimes

Never

I get hungry between meals and I like a snack

Always

Sometimes

Never

For lunch I could eat a BLT or a club sandwich

Always

Sometimes

Never

I would like lettuce, cottage cheese and a fruit salad for lunch

Always

Sometimes

Never

I often crave sweets

Always

Sometimes

Never

I feel better if I have some eggs or bacon or other kind of meat for breakfast

Always

Sometimes

Never

I can easily skip breakfast without getting hungry or tired

Always

Sometimes

Never

Toast and coffee is all I need for breakfast

Always

Sometimes

Never

I like to eat plain yogurt

Always

Sometimes

Never

A large steak dinner is my idea of a real meal

Always

Sometimes

Never

After a big meat dish I could eat dessert

Always

Sometimes

Never

Cereal low-fat yogurt or fruit for breakfast leaves me very shortly there after

Always

Sometimes

Never

Meals that contain meat make me feel tired and sluggish

Always

Sometimes

Never

Meat sits like a rock in my stomach

Always

Sometimes

Never

Between meals I get so hungry I need something sweet to eat

Always

Sometimes

Never

I like the taste of olive oil

Always

Sometimes

Never

Drinking coffee makes me jittery

Always

Sometimes

Never

I like to eat bacon

Always

Sometimes

Never

Avocado Tastes oily and fatty to me

Always

Sometimes

Never

Experience feeling of low blood sugar (fatigue weakness and lightheadedness)

Always

Sometimes

Never

I seem to want something more to eat even after a regular meal

Always

Sometimes

Never

Sweet foods like candy or cake tastes too sweet to me

Always

Sometimes

Never

I like butter on my potato or steak

Always

Sometimes

Never

Sweet things taste sweet enough to me

Always

Sometimes

Never

I feel a bit weak if I haven't eaten for 2 to 3 hours

Always

Sometimes

Never

I get irritable if I miss a meal

Always

Sometimes

Never

I would like lamb chops for dinner

Always

Sometimes

Never

I have sudden midmorning or mid-afternoon drops in my energy level

Always

Sometimes

Never

I enjoy drinking grapefruit or orange juice

Always

Sometimes

Never

Even after a big dinner I get hungry later in the evening or in the middle of the night

Always

Sometimes

Never

Meals composed of mostly vegetables and starches leave me satisfied until my next meal

Always

Sometimes

Never

I'm usually slow about getting started in the morning

Always

Sometimes

Never

I enjoy getting up early in the morning

Always

Sometimes

Never

Rather than three large meals a day I preferred to eat small quantities of food often

Always

Sometimes

Never

I have a tendency towards constipation

Always

Sometimes

Never

I would rather watch TV then pursue active and or stimulating recreation

Always

Sometimes

Never

I like pancakes or fruit for breakfast rather than something like ham and eggs

Always

Sometimes

Never

I prefer skim or low-fat milk rather than whole milk

Always

Sometimes

Never

I have one or more bowel movements every day

Always

Sometimes

Never

I must eat at least three meals a day

Always

Sometimes

Never

Cooked vegetables with cheese and rice are a satisfying main course for me

Always

Sometimes

Never

I've become very irritable and nervous the week before my menstrual period

Always

Sometimes

Never

For your menstrual cycle the symptoms are

Severe

Moderate

Mild

I enjoy doing a lot of exercise

Always

Sometimes

Never

When I'm thirsty I prefer to drink water rather than juice or carbonated drink

Always

Sometimes

Never

I tend to be nervous or high strung

Always

Sometimes

Never

I tend to crave and over eat foods high in fat

Always

Sometimes

Never

I tend to crave and overeat sweet foods and other carbohydrates

Always

Sometimes

Never

I'm tired in the morning even after 7 to 8 hours of sleep

Always

Sometimes

Never

How many servings of dairy products do you consume daily

Less than 2

2-3

More than 3

How many times have you lost and regained more than 20 pounds

Less than 2

2-3

More than 3

Are you currently lactating or trying to conceive

Yes

No

Do you have trouble falling asleep at bedtime

Always/often

Sometimes

Never

Meal Preference

Regular

Lacto-Ovo

Vegan

Do you have any of the below medical conditions or if they apply to you, have you been diagnosed by a physician?

Yes I have

No I have not

Check all that apply

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