Questionnaire Beginner — Your Body Programme

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QUESTIONNAIRE

YOUR BODY PROGRAMME

Our questionnaire is very extensive so please allow yourself plenty of time to fill it out thoroughly. The more information we can gain about you, the better our service will be.

Name *

First Name

Last Name

Phone Number

Email Address *

Date of Birth *

MM

DD

YYYY

Your details

Sex *

Please select.

Male

Female

Age *

Please select from the drop down menu.

Height (in cm) *

Please select in CENTIMETRES from the drop down menu.

Weight (in kg) *

Please select your weight in KILOGRAMS from the drop down menu.

Chest (in cm)

Please select your measurement in CENTIMETRES from the drop down menu. For information on how to measure yourself correctly please click here

Umbilicus / belly button (in cm)

Please select your measurement in CENTIMETRES from the drop down menu. For information on how to measure yourself correctly please click here

Hips (in cm)

Please select your measurement in CENTIMETRES from the drop down menu. For information on how to measure yourself correctly please click here

Thigh (in cm)

Please select your measurement in CENTIMETRES from the drop down menu. For information on how to measure yourself correctly please click here

Bicep (in cm)

Please select your measurement in CENTIMETRES from the drop down menu. For information on how to measure yourself correctly please click here

Physical Activity Level (PAL) *

How active is your job?

Not very active (Office worker / Taxi driver / Sedentary lifestyle)

Fairly active (Teacher / Hairdresser / Parent)

Active (Shop floor / Waiter / Busy parent)

Very active (Builder / Postman)

Highly active (Farmer / Construction worker / Extremely physical lifestyle)

Sitting *

How many hours a day are you sitting? Please remember that this includes driving / eating meals / screen time / possible work / public transport... BUT does not include hours sleeping.

Exercise Level *

For more information on the 3 levels click here. If you are unsure which level then we suggest you opt for the easier level to start with, we can progress you when needed.

Beginner (never exercised before / unfamiliar with free-weights)

Intermediate (exercised for 1 year plus / confident with all genres of exercise / good technique)

Advanced (exercised for 2 years plus / extremely good technique / strong with good core strength)

Current exercise routine

Please use the box to describe in as much detail as possible your current exercise routine, including any sports.

Training time

What time of day do you currently workout?

Training hours

How many hours a week are you exercising?

Your Goal

Goal *

What is your goal?

your body type

Body Type *

Select your body type. Please click here to refer to our website to understand your body type. It is important for us to get this correct as it will affect your entire programme. If you are unsure of your bodytype then send a full length photo of yourself clearly showing your frame to: hello@yourbodyprogamme.com (Remember to state your full name on the email)

Ectomorph

Ecto-Mesomorph

Mesoporph

Meso-Endomorph

Endomorph

Building muscle *

Choose the option which best describes your ability to build muscle.

Easy

Average

Hard

Unsure

Fat gain *

Do you gain weight (fat) easily?

Easily gain weight

Can gain and lose weight

Struggle to gain weight

Unsure

Joint size *

What size are your joints?

Small

Medium

Large

Unsure

Wrist size *

Place your thumb and middle finger around your wrist, select the relevant option.

Middle finger and thumb overlap

Middle finger and thumb touch

Middle finger and thumb do not touch

Frame size *

Choose the option which best describes your frame.

Very slight

Slight

Average

Large

Very large

Unsure

Metabolism *

Which option best describes your metabolism?

Fast

Average

Slow

Unsure

Fat Spots

Fat can accumulate on specific parts of the body due to hormonal imbalances. We are talking about excessive, stubborn, hard to eliminate fat. We have identified seven of the most common fat spots. Click here for more information before checking the correct box below.

Additional information

Information you feel may be relevant.

Contacting you *

We would like to use your contact details to let you know about our products and services that we think may be of interest to you. We won't share your details with any third parties. If you would like to be kept up to date in this way please check the box.

Yes, please contact me with updates and special offers

No thanks, please do not contact me with updates and special offers

Terms and Conditions *

By using this website you agree to comply with the Your Body Programme terms and conditions. When you click on “I have read and accept the terms and conditions of use” you agree to be bound by the terms that relate to registered users. Please click here to refer to our legal page.

I have read and accept the Terms and Conditions of use.

I have read and accept the Liability/Risk Disclaimer.

Thanks so much, we will create your programme within the next 4 working days and send you a link to your very own personal mini site.

Its time to invest in your health!

Luisa, Terry & the YBP Team

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