Pre Exercise Appraisal

  • General
  • Nutrition
  • Lifestyle
  • Sleep

Personal Data

This questionnaire consists of 36 questions and is divided into 4 parts. Please allow at least 10 minutes to complete and note it can't be saved until you have completed the whole form. PLEASE MAKE SURE YOU TAKE YOUR TIME AND FILL IN EVERY QUESTION. SKIPPING QUESTIONS WILL RESULT IN ERROR MESSAGES.

Full Name


DOB (yy/mm/dd)



Body Weight (kg)

Height (cm)

GENERAL: 1. What are your specific goals

GENERAL: 2. What timeline would you like to achieve your specific goal in?

GENERAL: 3. How Disciplined are you?

GENERAL: 4. How often do you train in a week?

GENERAL: 5. What form of training do you predominantly do

GENERAL: 6. How would you rate your overall health? (please ensure to expand on this in PAR-Q)


NUTRITION: 1. Have you lost weight before? If so what did you follow, a specific diet? What did you do?

If other, please state below

NUTRITION: 2. How many times do you eat per day? (Including snacks)

NUTRITION: 3. Do you regularly eat breakfast? If so what do you eat?

NUTRITION: 4. What time is your last meal?

If other, please state below

NUTRITION: 5. How do you feel after having lots of carbohydrates, especially gluten/wheat based products? (IE: bread, pasta, cereal etc– Please tick that applies

NUTRITION: 6. How do you feel after having protein?

If other, please state below

NUTRITION: 7. Do you eat and drink any dairy or soya products?

NUTRITION: 8. Would you say you have more of a sweet or savoury tooth?

NUTRITION: 9. Do you ever get any sugar cravings?

NUTRITION: 10. How many cups of tea/coffee/energy drinks per day do you have?

NUTRITION: 11. Do you drink alcohol? If so how often and quantity per week? Unit = either 1 25ml shot of spirit or 275ml of lager/wine

NUTRITION: 12. How much water do you drink during a day?

NUTRITION: 13. Would you say your emotional state affects the way that you eat?

NUTRITION: 14. What areas of your diet do you think you face the greatest challenge?

If other, please state below

DIGESTION: 1. How frequent are your bowel movements?

DIGESTION: 2. Do you experience any stomach acid reflux during or after meals?


LIFESTYLE: 1. What is your occupation and how many hours do you work?

LIFESTYLE: 2. What is your activity level at work?

LIFESTYLE: 3. How would you perceive your level of stress?

LIFESTYLE: 4. How often do you travel?

If other, please state below

LIFESTYLE: 5. How many late nights socially per week do you have?

LIFESTYLE: 6. Do you have more energy in the morning or the evening?

LIFESTYLE: 7. Do you have trouble switching off in the evening?

LIFESTYLE: 8. Do you get a dip in energy in the afternoon?

LIFESTYLE: 9. Relationship status? Children?


SLEEP: 1. Do you have trouble falling asleep at night?

SLEEP: 2. Do you have difficulty waking up in the morning? Do you use an alarm?

SLEEP: 3. Do you sleep less than 8 hours a night?

SLEEP: 4. Do you wake up once or more during the night?

SLEEP: 5. Do you sleep in a room with any light or noise?

SLEEP: 6. Do you go to bed later than 10pm?

SLEEP: 7. Do you get up earlier than 6am?

SLEEP: 8. Do you use medications (over the counter or prescription) to help you sleep?

SLEEP: 9. Do you currently take any health products or supplements?

If the answer is yes please list the products taken along with specific amounts (mg etc.) of each nutrient supplemented.