1. Have you ever suffered from any of the following:

a. Asthma                                                      YesNo

b. High or low blood pressure                             YesNo

c. Diabetes                                                    YesNo

(If yes, are you insulin-dependent?)                   YesNo

d. Joint pain / swelling                                     YesNo

e. Stress                                                       YesNo

f. Headaches (particularly after exercising)          YesNo

2. Do you suffer from frequent colds / flu            YesNo

3. Do you suffer from a lack of energy?               YesNo

4. Do you take a long time to recover from

strenuous, physical exercise?                            YesNo

5. Do you eat regular meals?                             YesNo

6. Do you eat a well-balanced diet?                    YesNo

7. Do you think you get the recommended vitamin

and mineral intake from the food you eat?           YesNo

9. Do you believe that balanced nutrition can help to

improve your focus and concentration?               YesNo

12. Do you think you drink enough fluids during / after

training / competing?                                       YesNo

13. Are you aware of the "30 minute window" for refuelling

your body after exercise?                                 YesNo

14. Are you aware of the "90-120 minute window" for

replacing protein in the muscles to aid repair?       YesNo

15. Do you believe that by reducing your recovery time

after exercise you can improve your performance?YesNo

16. Are you aware that taking antioxidants can reduce repair

and recovery time?                                         YesNo

17. Do you need to build muscle?                      YesNo

If yes, what, if any, muscle-building products

18. Areas of particular interest

Building stamina and power? Yes No

Helping my concentration, or mental toughness? Yes No

More energy shake-off that sluggish feeling? Yes No

Help my agility, joints? Yes No

Faster recovery time, less injuries or illness?  Yes No

Losing weight? Yes No

Gaining weight? Yes  No

19.Main priority? Other areas of interest/comments

20.How old are you?

21.How tall are you?

22.Approx weight?

23.What is your ideal goal?

24.Which sport/s are you involved with?

25.What is your involvement in sports? 

Junior               

Senior              

Manager/ Trainer

26. How serious would you say you are about your sport?

1. Extremely serious              
2. Fairly serious                    
3. It is more of a hobby         

27. How serious would you say you are about maintaining long term good health by looking after your body now?

1. Extremely serious              
2. Fairly serious                    
3. It doesn’t really worry me   

Name 

Email 

Telephone Evening 

Telephone Day

Mobile

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