Olivia Fitt Questionnaire

OLIVIA FITT QUESTIONNAIRE

Name

How many hours do you sleep at night?

Do you eat breakfast, with what? Do you snack in between meals, with what? How do you think you can improve in your diet?

Are you pregnant or have you given birth in the last 6 months? Have you had recent surgery?

How many days a week do you drink coffee? Alcohol? How much water do you drink daily?

Do you have chest pain when performing physical activity? Do you have bone or joint problems that cause you pain when exercising?

Do you exercise?

Never

Sometimes

Often

Do you have any other limitations that must be addressed when developing an exercise plan (i.e. diabetes, high blood pressure, high cholesterol, arthritis, back problems, etc.)?

What do you love and dislike about working out? What would you like to gain from our workout sessions?

Thanks for submitting!