The Balance Method Consultation Form

Name *

First

Last

Preferred name/nickname

N/A if not applicable

Email Address *

Mobile Number *

Date of birth *

What is your current occupation? *

Briefly describe an average day for you, from waking up to bedtime. *

What do your weekdays usually look like? Work, commute, stress levels, kids, pets, sleep – anything you think might affect training, energy, or nutrition.

How are you feeling in your body and mind right now? *

Physically, emotionally, or just in general. Energy, motivation, body image, confidence – anything that feels relevant.

What are your top 1-2 goals right now? *

Try to be specific – fat loss, build strength, feel more confident, get back into a routine, more energy etc.

Why do those goals matter to you? *

i.e “I want to feel stronger so everyday tasks are easier, I want to have more energy to play with my kids, or I want to lose weight so I feel more confident in my clothes.” There’s no right answer.

What do you feel has been holding you back?

Habits, mindset, time, not knowing where to start, fear of failure – anything at all that’s made it harder.

Describe a normal breakfast, lunch, dinner and snack day *

Include what you eat, portion sizes, timings, and if you eat with others.

How would you describe your relationship with food? *

E.g. all-or-nothing, consistent, emotional, improving, unsure … no judgement here.

What do you find hardest about nutrition? *

This might be structure, emotional eating, undereating, meal prep, sugar cravings, protein targets, etc

Have you ever struggled with disordered eating or been diagnosed with an eating disorder in the past? (Only if you’re happy to share.

Do you have any allergies or intolerances? *

(Especially ones you avoid or need to work around.)

Do you currently exercise? *

What does that look like (gym, home, classes, running, walking etc)? How often? What do you enjoy?

What’s your experience with strength training? *

Have you done it before? Any favourite movements or ones you struggle with?

How many training sessions would feel realistic for your current lifestyle? *

Don’t worry, we can always tweak it if life changes. Example: 2 full-body home sessions, 3 gym sessions, or 2 strength + 2 runs – whatever works best for you.

Any injuries or limitations I should be aware of? *

Past or current – anything that could impact training, even if mild (hyper mobility etc included here)

When do you usually train – or when would you ideally like to? *

(E.g. before work, after work, weekends, flexible, depends on the day)

Would you like me to set calorie/macro targets for you? If yes, please provide your age, weight and height below *

Are you currently using, or have you recently used, any fat loss medication (e.g. GLP-1 injections)? *

Approx. daily water intake *

Roughly how many steps do you do per day? *

If you drink alcohol roughly how much & how often?

On a scale of 1-10 ( 10 being the best) how well would you say you sleep?

Selected Value: 1

How do you usually relax or switch off? *

On a scale of 1 -10 (10 being extremely motivated) how motivated do you feel right now?

Selected Value: 1

On a scale of 1 – 10 (10 being the most) how confident are you that you can reach your goals?

Selected Value: 1

On a scale of 1-10 (10 being very stressed) how stressed would you say you usually are?

Selected Value: 1

Are you competitve? *

Are you more motivated by visible results, feeling stronger/fitter, ticking off habits – or something else? *

Would you describe yourself as introverted, extroverted, or somewhere in between? *

What do you think are your biggest hurdles when making changes? *

What do you think you can do to overcome them? *

Everyone learns and stays motivated differently. If there’s anything about how your brain works that would help me support you better (e.g. ADHD, autism, dyslexia, anxiety), you’re welcome to share, but only if you want to.

Sometimes I’ll suggest tracking your weight, measurements, photos, or food briefly, are you comfortable with this? *

Do you have any questions, worries or hesitations right now? *

Ask anything. I want you to feel confident and clear going into this.

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The Balance Method Consultation Form

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