SISU Nutrition Program Questionnaire

Thank you for your interest in the SISU Nutrition Program! We are excited to start working with you. Please fill out this questionnaire as thoroughly as possible so we can get the best understanding of your expectations and background.

Name *

First

Last

Date of Birth *

Age *

Weight *

Height *

Phone *

Email *

Hobbies/Interests *

What is your main goal? *

i.e. lose weight, gain weight, build muscle, etc.

What does your fitness/nutrition look like currently? *

Workout Information *

How many workouts per week? What do they look like?

Daily Activity (outside of the gym) *

Very Active
Active
Somewhat Active
Sedentary

Please Explain *

Dieting History (i.e. struggles and challenges) *

What are your expectations of your coach? *

What should your coach do if you fall behind on the plan to help you reach your goals? *

Name