Welcome To The Revolution - 60 Day Fat Loss Revolution

60 Day Fat Loss Revolution

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Client Onboarding Questionnaire

Welcome To The Revolution!

Please complete this questionnaire as honestly as possible. The information you provide will help me build your personalised plan and support you effectively.

Estimated completion time: 10 minutes.

Section 1 – Personal Information

Some description about this section

First Name

Last Name

Email

Mobile Number

Date of Birth

Occupation

Section 2 – Current Statistics

Some description about this section

Current Weight (kg)

Height (cm)

Section 3 – Your Goals

Some description about this section

Why have you joined the programme?

What would success look like in 60 days?

Primary goals:

Lose Weight

Gain Confidence

Improve Relationship with Food

Improve Fitness

Prepare for an Event (Hyrox etc)

Improve Energy

Other

Biggest Challenges

Emotional Eating

Weekends

Accountability

Motivation

Time

Consistency

Lack of Knowldege

Family Commitments

Previous Failed Diets

Tell me more about your biggest challenges.

Medical Information – please share any current medical conditions, current injuries, current medications and allergies/intolerances

Are you currently under medical supervision?

Yes

No

Lifestyle – Occupation Activity

Average Daily Steps:

Average Sleep Duration per Night:

Nutrition – have you tracked calories before?

Yes

No

Alcohol consumption:

How frequently do you exercise?

Is there any exercise you cannot do?

Commitment

Some description about this section

Why is now the right time?

On a scale of 1-10 how committed are you to achieving your goals?

What happens next?

✅ Complete onboarding questionnaire

✅ I review your information

✅ We arrange your start date

✅ You receive your personalised calorie allowance, protein guidance and support plan

Instagram:
@coachpetercheeseman

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