Sam Watt Personal Training
07985 107794
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Online Personal Training
Exercise and Nutrition Plan
Please provide as much detail as you can, so I can ensure your plan is as precise as possible
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Name
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First
Last
Email
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Telephone
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Date of Birth
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Height (in cm)
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Weight (in kgs)
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Occupation
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Gender
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Male
Female
Physical Condition
Rate your physical condition
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Option 1 - Couch Potato
Option 2
Option 3
Option 4
Option 5
Option 6
Option 7
Option 8
Option 9
Option 10 - Olympic Athlete!
Any past/current health issues or injuries? Please provide details
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Currently exercising
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Yes
No
If YES, for your RESISTANCE training, please provide full details for a typical week. Include all exercises as well as reps & sets
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If YES, for your CARDIOVASCULAR training, please provide full details for a typical week.
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Your Goals
Legs
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Maintain
Gain
Lose
Arms
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Mantain
Gain
Lose
Waist
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Maintain
Gain
Lose
Chest
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Maintain
Gain
Lose
Hips
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Maintain
Gain
Lose
Back
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Maintain
Gain
Lose
Nutrition
Please provide a detailed 2 day diary. All food, fluid and supplements as well as portion sizes
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List foods and drinks you don't dare consume!
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