Soft Consultation Questionnaire
|
| Full Name
|
|
|
| E-mail
|
|
|
| Phone Number
|
|
|
| Preferred method of contact
|
|
|
| What inspired you to reach out to RFC?
|
Build confidence, Manage stress, Feel stronger, etc.
|
| Have you participated in fitness/wellness program before?
|
Yes No
|
| If yes, what activities/Workouts did you enjoy?
|
Walking, Yoga, Weights, Team sports, etc.
|
| Current activity level?
|
Sedentary Light activity Active Very active
|
| Current or past injuries we should know about?
|
Knee, Shoulder, Back, etc.
|
| Medical conditions or limitations that effect exercise?
|
Heart, Diabetes, Asthma, Arthritis, etc.
|
| Food allergies, Sensitivities, or dietary restrictions?
|
Lactose intolerant, Gluten-free, Vegan, Vegetarian, etc.
|
| Medications that may affect energy\ appetite\ or performance?
|
|
|
| How would you describe your current eating habits right now?
|
Structured meals, Irregular Schedule, Emotional Eating, etc.
|
| Do you find it difficult to maintain consistent energy levels?
|
Rarely Sometimes Often
|
| What foods make you feel your best? Anything that triggers discomfort/cravings?
|
|
|
| Your main health/fitness goals for the next 3 months
|
|
|
| What challenges or roadblocks have made it hard to stay consistent?
|
|
|
| Optional: If you could feel one thing more often in daily life, what would it be?
|
Calm, Confident, Connected, Stronger
|
| I consent to RFC storing my responses for program personalization.
|
First option Confidential • We only use this information to personalize your program.
|
|
|
