Online Gym Programming Questionnaire

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Online Gym Programming Questionnaire

Complete the below questionnaire and we will aim to have your tailored gym program emailed to you within 48 hours!

Name *

First

Last

you you program

Email *

DOB *

What is your level of gym experience? *

No experience
Previous experience but not current
Semi-regular gym attendee
Regular gym attendee

What is your current level of physical activity *

Nil
Low (1-2 days weekly)
Medium (3-4 days weekly)
High (5-7 days weekly)

Where will you be conducting your gym program? *

Home
Commercial Gym

If you are conducting your gym program at home please list what equipment you have access to, if any:

What are the goal/s of your gym program? *

Increase muscle bulk (strengthen & build visible muscle)
Increase lean muscle (strengthen but not build muscle bulk)
Lose weight
Increase cardiovascular fitness

How long would you like to train for? *

30 minutes
45 minutes
60 minutes

Please list any current injuries you have or any limitations from current or previous injuries: *

If you are unable to perform particular exercises or be in particular positions please mention here

Please list any exercises you would not like to do or positions you would not like to be in *

What body part/s would you like to focus on? *

Shoulders
Arms i.e. biceps/triceps
Chest
Upper/mid back
Abdominals
Hips/gluteals
Thighs i.e. hamstrings/quads
Legs i.e. calves/ankles

Please add any other relevant information you would like us to be aware of prior to writing your program *

Would you like ongoing support or check-ins to track your progress or adjust your program, or do you prefer a self-guided approach?

Regular check ins via email would be great
I'll test it out on my own and reach out if I need

Visit Us

Spark Health Co

32 Melville St, Numurkah

VIC 3636

> Click here for directions

Tel: 0492 880 202
E : admin@sparkhealthco.com.au

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