Your contact details
Please enter the email address you'd like to use for correspondence for this programme.
Messaging is an important part of the coaching process. Please provide your mobile number for messaging via whatsapp.
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Your goals.
Everyone has their own reasons for working on their health and fitness. Please share what you hope to get out of this coaching experience by rating the importance of the following:
1 = lowest priority, 10 = highest priority.
1 = lowest priority, 10 = highest priority.
1 = lowest priority, 10 = highest priority.
1 = lowest priority, 10 = highest priority.
1 = lowest priority, 10 = highest priority.
1 = lowest priority, 10 = highest priority.
**Please note, advice on whether or not you need to take medication will be a discussion held between you and your doctor only. The purpose of this question is to assess if getting off medication, if you are on any, is a priority for you.
1 = lowest priority, 10 = highest priority.
1 = lowest priority, 10 = highest priority.
1 = lowest priority, 10 = highest priority.
1 = lowest priority, 10 = highest priority.
Record a rough estimate of your weight in kilograms (kg)
Your current exercise and nutrition habits.
Please advise if you have a current injury or any pain that impacts movement for you.
Check all that apply.
Please select…
Please share your general food preferences. You can refine your choices and add more detail later.
Here are some foods that are high in protein. Please check off all that you like and WILL eat.
Here are some foods that are high in protein. Please check off all that you like and WILL eat. Here are some common vegetables. Please check off all that you like and WILL eat.
Here are some foods that are higher in carbohydrates (sugars and starches). Please check off all that you like and WILL eat.
Here are some foods that have healthy fats. Please check off all that you like and WILL eat.
A food allergy is when the body's immune system reacts unusually to specific foods. If you are sensitive to any food, please check 'No' and see the question below.
Check all that apply.
If you are sensitive to any foods, please check 'yes' in the following food intolerance question.
Check all that apply.
*Please note;
Lactose intolerance is when you can't digest lactose, the sugar found in dairy products. You'll often get symptoms like stomach pain, gas, and diarrhea. With a milk allergy, the symptoms affect more than just your digestive tract. A milk allergy is when your immune system thinks dairy is a foreign invader and attacks it by releasing chemicals called histamines. Symptoms can range from wheezing problems to vomiting and diarrhea.
Such as eating a vegetarian or kosher diet, abstaining from grains etc...
Check all that apply.
Check all that apply.
Check all that apply.
Please select...
Please select...
Please select...
(1 = I know very little; 5 - I have some knowledge; 10 = I'm a nutrition expert)
(E.g. jogging, brisk walking, cycling, boxing, fast swimming, etc.) Please select…
(e.g. lifting weights, bodyweight resistance classes (such as frame), resistance weight training classes (such as a body pump class).
(e.g. sprinting, Crossfit, MMA, intense circuit-based classes, etc.)
(e.g. gentle walking, yoga, golf, etc.) Please select...
Your general health details.
A lot of factors can affect health and fitness such as your metabolism and gender/sex. This section helps understand how to create the most personalised program for you.
Check all that apply.
Select the gender you most identify with.
Check all that apply.
Check all that apply.
A brief description of dates of diagnosis, where the condition is in the body, or the length of time you have been in remission for example.
Check all that apply.
Such as pain killers or medications for acid reflux.
How long you smoked for, when you gave up, and a brief description of why you gave up.
If you had low levels of a particular vitamin or mineral, if it was advised that you should watch cholesterol levels, make dietary changes, improve cardiovascular health, etc.
Blood testing can be a useful indicator of current health and also identify vitamin and mineral deficiencies. I do not advise taking specific supplements, such as vitamin D or omegas unless a blood-work test highlights a need to take them.
I work with Thriva, an established and reputable company, that provides home-based testing kits. Your results will be private and discussed with you only by a qualified GP.
Your work life.
This section looks at other factors that affect health and fitness are those like stress, social support, and time spent on work, family, and other responsibilities.
Choose the answer that best applies.
Choose the answer that best applies.
Choose the answer that best applies.
Choose the answer that best applies.
1 = no stress at all, 10 = the most stressed you've ever been.
Choose the answer that best applies.
For example, does your additional activity give you points towards any benefits or bring medical/life assurance costs down?
Home Life
1 = no stress at all, 10 = the most stressed you've ever been.
Choose the answer that best applies.
Personal information consent
1. The Compound Club Ltd Ta. Boxing, Bars & Bells does not share or sell your information. The only person who will have access to your data are you and your coach, James Toff.
2. It is up to you to decide what and how much data you provide. You can share everything with or provide very little information, depending on how much information you wish to divulge and how much you think this will help your progress. You can write your life story or simply type 'N/A' if you don't wish to share some information. If you have concerns, please request a discussion and agree on how much information you are willing and able to share.
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3. The information you can choose to share includes: measurements, photos, and information about your health, race and ethnicity, personal history, and family and professional details. Your privacy is paramount and all of your data, including your images, is encrypted. Your information will not be shared with any third parties.
The Compound Club Ltd Ta. Boxing, Bars & Bells has the right to store and process any information I provide and will not share any information with anyone else.
Please sign if you consent.
Medical release
Every individual who has taken part in an online coaching program with The Compound Club Ltd has improved their health and fitness in some way.
A key part of that is that every client takes full responsibility for their health and the monitoring of it.
It's important that you understand:
1. Any advice you receive does not replace the advice of a trained medical doctor.
2. It is your responsibility to work directly with your physician before, during, and after seeking coaching with The Compound Club Ltd.
3. If you choose to be coached The Compound Club without prior consent of your physician, you agree to accept full responsibility for your decisions and to hold harmless The Compound Club, James Toff, and any affiliated companies from any liability with respect to injury to you or your property arising out of or connected with your use of the information discussed.
Please sign if you consent.
- By submitting this questionnaire you are agreeing to ourPrivacy Policy,Terms of Use, and Cookies Policy.
Please review them and then click submit.
