Sports Nutrition Questionnaire
Which of these words best describe your lifestyle
Calm
Stressed
Active
Do you think you get 100% of the daily nutrition to support your activities?
Yes
No
Sometimes
Do you take Nutritional Supplements e.g. Vitamins,Minerals etc.?
Yes
No
Sometimes
Do you experience a loss of energy during the day?
Yes
No
Sometimes
Which of these items do you take care of?
Fuelling Up,Pre Event
Refuelling During the Event
Correct Hydration
Immune System Support
Circulatory System Support
General Nutrition
Recovery Post Event
Repair
What is your view of your current performance and fitness level?
Very Poor
Poor
Average
Good
Very Good
Other
If Other -Explain:
How many litres of water do you drink daily?
1
2
3
4+
How many times a week do you train?
1
2
3
4
5+
Would you like to:
Lose weight?
Gain Weight?
Control Weight?
If we could show how to improve current performance would this be of interest?
Yes
No
What do you normally spend on lunch?
under £1
£1 to £2
£2 to £3
over £3
What do you think would be a reasonable daily budget for a programme?
£1
£2
£3
£4
Do you think exercise alone can help you achieve your goals?
Yes
No
Do you have any specific health issue you would like to improve? e.g. skin, heartburn,digestion
Thank you for taking time to complete our Sports Nutrition Questionnaire, we'd love to help do you want to proceed?
Yes
No
Whats your Name?
What's your Primary Sport
Your Age?
Height?
Weight?
Email address:
Daytime Tel No.
Evening Tel.No.
Whens the best time to call you?
An apple a day way to health and wealth
