Sport Survey

1. What is your sport involvement? 

• Just want to shape up

• I do regular sport and want to really improve

• Professional / competitor

2. Any particular aspects you would like help with?

• Building my strength / stamina

• Helping my mental toughness / concentration

• Help with my agility, joints

• Faster repair & recovery after activity

• Reducing injuries or illness

• Building Muscles

• Other

3. What is your level of fitness?

• none, don't do any sport

• am quite fit (i.e. busy mum, lots of walking, etc)

• play sport for fun

• play sport competitively

• physically active job

• Other

4. Which of these best describes your own lifestyle?

Calm Active Stressed

5.Do you take nutritional supplements (vitamins/minerals/proteins)

Daily Never Sometimes

6.Do you experience a loss of vitality during the day? Give details

YesNo Occasionally

7. Do you eat 3 meals a day?

Yes No

if no, what meals do you skip?

9. Do you smoke?

Yes No

12. Do you want to lose / gain weight?

Lose weight but not now

Lose weight before going

Gain weight

I am at the right weight

Please provide details, such as how long you have been at your current weight?

13. How much still water to you drink each day?

3+ litres

2+litres

1+ litre

odd glass

Fizzy drink consumption :

14.Any health challenges? IBS, Diabetes, Arthritis, sleep problems, high cholesterol, heart disease etc etc

15. What type of work do you do i.e. sedentary, active, at home

16. How old are you?

17 .Additional information - what sport do you do, how often do you train, etc.?

Name  

Email 

Telephone Day         

Telephone Evening 

Best time and day  to call  

Telephone consultations between 9am -9 pm on landline telephones