Questionnaire - Natty ATP

Contact Information

First Name

Last Name

Date

Age

Height

ft/cm

Weight

lb/kg

Exercise

What exercise activities do you currently take part in (e.g., running, weightlifting, group exercise, etc.)?

How many days per week do you get at least 60 minutes of moderate-intensity exercise?

ON A SCALE OF 0 TO 10, HOW IMPORTANT IS YOUR FITNESS GOAL FOR YOU?

Weight Loss

Healthier Lifestyle

Bodybuilding

Body Recomposition

Power, Muscular Endurance, and Agility Training

Diet

On a scale of 0 to 10, do you consider your overall diet to be healthy?

Do you have any food allergies?

How would you rank your daily salt intake?

Low

Medium

High

How would you rank your daily sugar intake?

Low

Medium

High

How would you rank your daily fat intake?

Low

Medium

High

Are you a vegan or vegetarian?

How many alcoholic drinks do you consume per week?

Do you consume caffeinated beverages such as coffee, tea, soda, and/or energy drinks? How many per week?

LIFESTYLE

Do you feel like you get enough sleep and wake up feeling rested each day?

On a scale of 0 to 10, how would you rate your average level of stress?

What techniques do you currently use to manage your stress levels?

Do you smoke tobacco or use a vaporizer alternative?

TOBACCO

VAPORIZER

OCCUPATION

What is your occupation?

Does your occupation require extended periods of sitting?

Does your occupation require repetitive movements?

Does your occupation require you to wear shoes with a heel (e.g., dress shoes, work boots)?

RECREATION

Do you partake in any recreational physical activities (golf, skiing, etc.)?

Do you have any additional hobbies (gardening, fishing, music, etc.)?

MEDICAL

Please list out any past musculoskeletal injuries:

Please list out any past surgeries:

If you have experienced injuries or surgeries, were they properly rehabilitated and did you receive clearance from a doctor to return to physical activity?

Are you on any medications, and if so, have you received clearance from your doctor to take part in physical activity?

Additional Notes:

Usual Intake Worksheet

Instructions
In your own words, describe a normal day of eating/drinking for you, beginning with
when you wake up through the hours accounted for sleep. In addition to providing your
consumption details, include any explanation on why you chose to eat at the given time
periods (if applicable).

Week Days

Time: Early Morning

Time: Mid-morning

Time: Midday

Time: Afternoon

Time: Evening

Weekends

Time: Early Morning

Time: Mid-morning

Time: Midday

Time: Afternoon

Time: Evening

Contact Information

First Name

Last Name

Date

Age

Height

ft/cm

Weight

lb/kg

Exercise

What exercise activities do you currently take part in (e.g., running, weightlifting, group exercise, etc.)?

How many days per week do you get at least 60 minutes of moderate-intensity exercise?

ON A SCALE OF 0 TO 10, HOW IMPORTANT IS YOUR FITNESS GOAL FOR YOU?

Weight Loss

Healthier Lifestyle

Bodybuilding

Body Recomposition

Power, Muscular Endurance, and Agility Training

Diet

On a scale of 0 to 10, do you consider your overall diet to be healthy?

Do you have any food allergies?

How would you rank your daily salt intake?

Low

Medium

High

How would you rank your daily sugar intake?

Low

Medium

High

How would you rank your daily fat intake?

Low

Medium

High

Are you a vegan or vegetarian?

How many alcoholic drinks do you consume per week?

Do you consume caffeinated beverages such as coffee, tea, soda, and/or energy drinks? How many per week?

LIFESTYLE

Do you feel like you get enough sleep and wake up feeling rested each day?

On a scale of 0 to 10, how would you rate your average level of stress?

What techniques do you currently use to manage your stress levels?

Do you smoke tobacco or use a vaporizer alternative?

TOBACCO

VAPORIZER

OCCUPATION

What is your occupation?

Does your occupation require extended periods of sitting?

Does your occupation require repetitive movements?

Does your occupation require you to wear shoes with a heel (e.g., dress shoes, work boots)?

RECREATION

Do you partake in any recreational physical activities (golf, skiing, etc.)?

Do you have any additional hobbies (gardening, fishing, music, etc.)?

MEDICAL

Please list out any past musculoskeletal injuries:

Please list out any past surgeries:

If you have experienced injuries or surgeries, were they properly rehabilitated and did you receive clearance from a doctor to return to physical activity?

Are you on any medications, and if so, have you received clearance from your doctor to take part in physical activity?

Additional Notes:

Usual Intake Worksheet

Week Days

Time: Early Morning

Time: Mid-morning

Time: Midday

Time: Afternoon

Time: Evening

Weekends

Time: Early morning

⁠Time: Mid-morning

Time: Midday

Time: Afternoon

Time: Evening

Lifestyle and Health History Questionnaire

Lifestyle and Health History Questionnaire

Contact Information

Exercise

Diet

LIFESTYLE

OCCUPATION

RECREATION

MEDICAL

Usual Intake Worksheet

Week Days

Weekends

Contact Information

Exercise

Diet

LIFESTYLE

OCCUPATION

RECREATION

MEDICAL

Usual Intake Worksheet

Week Days

Weekends