New Client Questionnaire This questionnaire will be used to determine your initial plan and structure. The more detailed you are the more comprehensive we can make your plan. Full Name*Email* AgeHeightWeightWhat types of foods do you normally eat or like?Do you generally eat?healthier unprocessed foodsunhealthy heavily processed foodsAny Food allergies or foods that you dislike?Any Digestive issues?Current supplements and/or medicationWhat is average weekly schedule?What is your workout history?Any illnesses (heart condition, chest pain, dizziness, bone/joint problems, blood pressure issues, etc)Do you have current pain? If so where and what's the cause?Gym routine (days you workout, number of reps/sets/exercises, etc.)Short Term Health/Fitness GoalsLong Term Health/Fitness GoalsIs there a special event or show you want to get ready for? If so whats the date?Short Term Life GoalsLong Term Life GoalsHas anything in the past helped your reach your goals? Ie certain diet or other routines?Do you have a preferred diet?Were you obese during your childhood years? Please explain.Any problem areas or areas of focus?Activity levels during childhood years?What is your profession/career?How are your energy levels on a daily basis?How many hours of sleep do you get on average per night?How are your general stress levels?Do you have an easy time staying leaner year round or do you accumulate fat easy?Upload Current Profile Photos (Front/Side/Back) Drop files here or Accepted file types: jpg, gif, png, pdf, jpeg. What are you most excited for through this process and what are you most fearful of?* I Understand and AgreeMindBodyBuild is not a licensed Dietitian or Medical practitioner. All information shared is based on personal experience and is not intended to treat or diagnose any illness or disease. These are all recommendations given by MindBodyBuild. Please consult with your physician before beginning any new physical program. By submitting this, I agree and understand that all information shared by MindBodyBuild is advice and is not meant to be followed to treat, diagnose, or cure any illness.