Please complete all 4 sections of the questionnaire.
Please answer the following questions as completely and honestly as you can.
1. What outcomes are you looking to experience as a result of your exercise programme?
2. What is the single most important goal for you to achieve with your exercise programme?
3. In what time frame do you expect to achieve your goals?
4. How much time (per day or week) are you willing to engage in activity that works towards your goals?
In each case, please complete the statements using the more appropriate of the two options.
1. During workouts the more important thing for me is
---to feel there is freedomto feel there is structurea combination of both
2. When I need to reduce stress I prefer doing activities that are
---exciting, dangerous, and give me a chance to "let off steam"practical and relaxinga combination of both
3. I enjoy exercise more when it
---involves routine that I can adhere toinvolves "play" and offers varietya combination of both
Please answer the following questions.
1. How often do you participate in sporting and physical activities (inside and outside work)?
---3-4 times per month2-3 times per week4+ times per week
2. What hobbies do you enjoy?
3. What exercise programme and/or physical activities are you currently undertaking?
Please provide the following information.
Date of birth
Contact number (no spaces)
I would prefer to be contacted by