SKINNY-FAT TRANSFORMATION



ONLINE TRANSFORMATION PROGRAM Client Assessment Form

Please fill out this application form to the best of your ability and send it to my email oskar@

I promise I will not share any of your information without your written permission.

(1/14) Personal data

|Email address | |

|Full name | |

|Gender | |

|Age | |

|Location | |

|Occupation | |

|Birthdate (Month/Day/Year) | |

|Phone Number | |

(2/14) Body stats

|Height in CM | |

|Bodyweight in KG | |

(3/14) What is your body composition?

(Put an X to fill out)

|Skinny-fat | |

|Skinny | |

|Fat | |

|Lean and fit | |

(4/14) Define your ideal physique.

How does your ideal physique look like? Is it wide shoulders and a flat waist? Is it big arms and defined abs? Be as specific as possible and include examples if you can.

(5/14) Why do you want to transform your body?

Tell me why you want to transform. Be as specific as possible. You need to have a strong why (or several strong whys) to be successful in your transformation. Be honest here, there’s nothing to be ashamed of. I have been through it all myself and I won’t share this with anyone.

(6/14) Do you have access to a chin up bar?

(Put an X to fill out)

|Yes, I have access to a chin up bar. | |

|No, I don’t have access to a chin up bar. | |

|No, I don’t have access to a chin up bar but I will get access to one if it’s | |

|required. | |

(7/14) How many days per week can you train?

(Put an X to fill out)

|4 days. | |

|5 days. | |

|6 days. | |

|7 days. | |

(8/14) How long time can you train on these days?

(Put an X to fill out)

|20 minutes. | |

|30 minutes. | |

|45 minutes. | |

|60 minutes. | |

|75 minutes. | |

|90 minutes. | |

|105 minutes. | |

|120 minutes. | |

|As long as it takes. | |

(9/14) What are your current estimated maxes on:

Note: If you don’t know your maxes, feel free to either put an estimate or skip this question.

|Chin up | |

|Push up | |

|Barbell bench press | |

|Barbell squat | |

|Barbell deadlift | |

|Barbell press | |

|Barbell row | |

(10/14) Do you play any sports?

Put an X below (if you play a sport, please write the name of it and how often you do it).

|Yes, I play… | |

|No. | |

(11/14) Injuries

Do you have any injuries, health problems or limitations that might prevent you from doing anything? If so, please provide a brief description.

(12/14) Training History

Have you followed any training programs in the past or do you follow one now? If so, please list your training program(s) below and tell me about your results with them. Be as specific as possible.

Are there any exercises that bother you?

Mobility test: Can you do a full bodyweight squat (all the way down) without wearing any shoes and with your heels planted on the floor?

If yes, how long time can you maintain the bodyweight squat position?

If no, how far down can you go?

(13/14) Dietary Preferences

What does your daily eating look like? Please be as honest as possible.

Do you feel addicted to sugar or any other types of foods?

Have you followed any diets in the past? List the diets below and the results you had with them.

Do you often get bloated, gassy or constipated after eating meals?

How much alcohol do you consume on a weekly basis?

Do you currently take any drugs, medicines or supplements? If so, please list them below:

What is your dietary budget each month? (Knowing your dietary budget will give me a great idea about the kind of meals I can include in your diet).

Are there any foods you absolutely dislike?

Do you have any food intolerances or food allergies?

(14/14) Final Questions…

Is there anything else I should know of? This is the place to put it.

How did you find ? (Put an X)

|YouTube | |

|Google Search (please specify what you searched for | |

|if you can remember) | |

|Forum. | |

|FaceBook | |

|Twitter | |

|Instagram | |

|Starting Strength Forums | |

|Reddit | |

|4Chan | |

|Through a friend (please name them so I can thank | |

|them) | |

|Other (please define) | |

Send the completed application form to my email oskar@

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