First name
Last name
Sex
Date of birth
E-mail
Mobile
Address data
Street name and house number
Postal Code
residence
Physical composition
Tips for measuring scale:
Weight
Length (cm)
Foto huidige fysiek:
Voorkant (zonder aanspannen)
Zijkant (zonder aanspannen)
Achterkant (zonder aanspannen)
Photo front side back
Mobility
Ankle mobility (left)
Mobility ankle (L)
0=Pain during execution
1=Poor execution
2=Medium performance
3=Good execution
Ankle mobility (right)
Mobility ankle (R)
0=Pain during execution
1=Poor execution
2=Medium performance
3=Good execution
Hip mobility
Hip mobility
0=Pain during execution
1=Poor execution
2=Medium performance
3=Good execution
Shoulder mobility (left)
Shoulder mobility (L)
0=Pain during execution
1=Poor execution
2=Medium performance
3=Good execution
Shoulder mobility (right)
Muscle size You can purchase a measuring tape at a department store near you! If this does not work now, we will measure this at a later time. We discuss this during the intake.
Right leg
size of right leg?
Resourse
size medium
Right arm
size of right arm
Lifestyle
Daily life
Physical activities while doing your daily activities?
Activity level
None to little (sedentary work ~ exercise 1-2 times a week)
Light exercise (Standing work ~ exercising 3-4 times a week)
Normal exercise (Average work ~ exercise 5 times a week)
Heavy exercise (Lots of walking at work ~ exercise 6 times a week)
Very strenuous exercise (Heavy work ~ exercise 7 times a week)
Spare time
Do you smoke?
How many cigarettes
Do you drink alcohol?
How many drinks
Mental and physical fitness
Sleep
Tired or rested
How much stress do you experience in daily life?
Stress
Supplements
How easily do you gain weight?
Weight
How well can you eat by feeling? To clarify: Do you know how many calories you consume every day without registering?
Feeling
Sporty background
To play sports
Exercise
What is your level with regard to fitness/strength training?
Train
Training method
Sporting objective
Waarom heb je deze doelstelling?
Doelstellingwaarom
SMART OBJECTIVE(S)
SMART short
SMART long
Contribution Trainer
Obstacles
What are the chances that you will achieve your goals?
Achieving objective
What are the chances that you will continue to build muscle mass forever (consistency)
To persevere
Needs
Training per week
Which day(s) would you like to train?
Which part of the day would you like to train?
Op welke datum wil je het liefst van start met het programma? (Zodat jij gaat groeien!)
Welke datum?
Power supply
Number of meals per day
1 meal
2 meals
3 meals
4 meals
5 meals
6 meals
Snacks
Flexible nutritional plan
Flexible
Liter of water
Do you pay attention to the number of kilocalories per product?
Health
What injuries
Have you ever become dizzy or fainted during exercise?
Have you ever had an epileptic seizure in the past?
Has a doctor ever advised you not to exert maximum physical effort? ?
Medicines
Important
Passed
Other Coach
Instagram
Instagram
Anything else to report?
Questions or remarks
Send
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