QUESTIONNAIRE 

YOUR BODY PROGRAMME

Our questionnaire is very extensive so please allow yourself plenty of time to fill it out thoroughly. The more information we can gain about you, the better our service will be.
Name *
Name
Date of Birth *
Date of Birth
Your details
Sex *
Please select.
Please select from the drop down menu.
Please select in CENTIMETRES from the drop down menu.
Please select your weight in KILOGRAMS from the drop down menu.
Please select your measurement in CENTIMETRES from the drop down menu. For information on how to measure yourself correctly please click here
Please select your measurement in CENTIMETRES from the drop down menu. For information on how to measure yourself correctly please click here
Please select your measurement in CENTIMETRES from the drop down menu. For information on how to measure yourself correctly please click here
Please select your measurement in CENTIMETRES from the drop down menu. For information on how to measure yourself correctly please click here
Please select your measurement in CENTIMETRES from the drop down menu. For information on how to measure yourself correctly please click here
Your Physical activity
Physical Activity Level (PAL) *
How active is your job?
How many hours a day are you sitting? Please remember that this includes driving / eating meals / screen time / possible work / public transport... BUT does not include hours sleeping.
Please give us a brief description of your occupation and work environment.
Exercise Level *
For more information on the 3 levels click here. If you are unsure which level then we suggest you opt for the easier level to start with, we can progress you when needed.
Exercise history
So we have an idea of your exercise level, please give us a brief summary of your exercise history.
Please use the box to describe in as much detail as possible your current exercise routine, including any sports.
What time of day do you currently workout?
How many hours a week are you exercising?
Your Goal
What is your goal?
your body type
Body Type *
Select your body type. Please click here to refer to our website to understand your body type. It is important for us to get this correct as it will affect your entire programme. If you are unsure of your bodytype then send a full length photo of yourself clearly showing your frame to: hello@yourbodyprogamme.com (Remember to state your full name on the email)
Building muscle *
Choose the option which best describes your ability to build muscle.
Fat gain *
Do you gain weight (fat) easily?
Joint size *
What size are your joints?
Wrist size *
Place your thumb and middle finger around your wrist, select the relevant option.
Frame size *
Choose the option which best describes your frame.
Metabolism *
Which option best describes your metabolism?
Your general health
Conditions *
Have you or do you suffer from any of the following? If yes please give details below.
Pregnancy *
Are you, or is there any possibility that you might be pregnant?
Injuries *
Do you have any past or present injuries?
Surgery *
Have you ever had surgery?
Joint pain *
Do you suffer from joint pain?
Tension or soreness *
Do you have tension or soreness in a specific area?
Colds and flu
Do you frequently suffer from colds and/or flu?
Headaches
Do you frequently suffer from headaches?
Medication *
Are you currently taking any medication?
Supplements / Remedies *
Are you currently taking any supplements or remedies?
Fat can accumulate on specific parts of the body due to hormonal imbalances. We are talking about excessive, stubborn, hard to eliminate fat. We have identified seven of the most common fat spots. Click here for more information before checking the correct box below.
Please use this space to tell us of any other condition / issue you may have.
Your digestion
Digestion issues
Do you regularly experience any of the following?
Do you know of any foods which cause you digestive problems?
Your lifestyle
How do you travel to work and how long does it take?
How many hours a week do you work?
On average how many hours per week do you spend on a computer?
Hobbies
Do you have any hobbies?
What do you do to relax?
Sleep
Do you have trouble sleeping?
On average how many hours of sleep do you have per night?
Interrupted sleep
Do you have interrupted sleep?
Sleep needed
Do you need more than 8 hours of sleep per night?
What time do you generally go to sleep?
What time do you generally wake up?
Energy
Do you suffer from low energy?
Morning energy
Do you find it difficult to get going in the morning?
Stress
Do you suffer from stress on a regular basis?
Do you smoke?
Passive smoking
Do you live or spend time in a smoky atmosphere?
Toxic Exposure
Do you live, exercise or work in a city or by a busy road?
Your nutrition
What time do you eat breakfast on a weekday / workday?
Please give us as much detail as possible including quantity. List different examples if you vary your breakfast.
What time do you eat lunch on a weekday / workday?
Please give us as much detail as possible including quantity. List different examples of your lunch.
What time do you eat dinner on a weekday / workday?
Please give us as much detail as possible including quantity. List different examples of your dinner.
Do you eat between meals? Please give details of what you eat, the time and the quantity.
Do your eating habits change at the weekend? Please give us as much information as possible. For example do you allow yourself a small treat? Or literally eat what you want from Friday night to Monday morning?
How much water do you drink per day?
Select the average number of cups of tea (with caffeine) per day.
Select the average number of coffees you drink per day.
Do you drink alcohol? If so, how many units per week? To give you a rough guide: 1 pint of beer / 175ml glass of wine = 2.3 units. 125ml glass of champagne = 1.5 units. Single spirit = 2.5 units.
How do you consume your alcohol units?
Alcohol of choice
Please select which alcoholic drinks you consume?
Sweetener
Do you regularly consume artificial sweeteners?
Information you feel may be relevant.
Contacting you *
We would like to use your contact details to let you know about our products and services that we think may be of interest to you. We won't share your details with any third parties. If you would like to be kept up to date in this way please check the box.
Terms and Conditions *
By using this website you agree to comply with the Your Body Programme terms and conditions. When you click on “I have read and accept the terms and conditions of use” you agree to be bound by the terms that relate to registered users. Please click here to refer to our legal page.
Thanks for taking the time to complete our questionnaire. If you're happy with your answers please now click submit.