PPT10 Pre-Program Consultation Form Welcome! Now before we kick off, we need a little bit of homework from you. There’s a bit there, but filling it in will go a long way to helping us do our best work with you. Section 1: The BasicsLet’s get the foundational details sorted so we can hit the ground running. Full NameBest Contact NumberCurrent AgeCurrent Height (cm)Current Height (cm)What is your primary occupation, and how active are you during the workday? Sedentary (Desk job, mostly sitting) Lightly Active (Some walking/standing, e.g., teacher, retail) Moderately Active (On your feet most of the day, e.g., trades, nursing) Highly Active (Physically demanding labor) Section 2: Health & Scope of PracticeYour safety and results are the priority. We need to know what we are working with. Do you have any diagnosed medical conditions, metabolic issues, or injuries that affect your nutrition or training? Yes No If Yes, please detail:Are you currently taking any medications or supplements? Yes No If Yes, please detail:Do you have any diagnosed food allergies or strong intolerances (e.g., peanut, gluten, lactose)? Yes No If Yes, please detail:Do you suffer from any known/diagnosed digestive conditions (e.g., Crohn’s, ulcerative colitis, IBS, reflux)? Yes No If Yes, please detail:Have you ever been diagnosed with or treated for an eating disorder (e.g., anorexia nervosa, bulimia nervosa)? Yes No Note: PPT10 is a structured nutrition program and may not be suitable for individuals with a history of disordered eating. If yes, we will discuss this privately to ensure this program is safe for you.If Yes, please detail:Have you ever been recommended by a healthcare professional to see a dietitian in regards to health concerns? Yes No If Yes, please detail:Do you ever feel faint, dizzy, or lose balance unexplained? Yes No Has a medical practitioner ever told you that you suffer from a heart condition (heart disease or stroke), or do you experience unexplained pain/discomfort in the chest during exercise? Yes No Are you currently seeing a physiotherapist, psychologist, or doctor for any ongoing injuries, mental health issues, or health conditions? Yes No If Yes, please detail:Section 3: Goals & OutcomesWhat does success look like for you at the end of these 10 weeks? What is your primary goal for the PPT10 program? Fat Loss (Dropping body fat while maintaining muscle) Muscle Gain (Building lean mass, accepting some scale weight increase) Recomp/Maintenance (Improving body composition at current weight) Education & Habits (Learning how to eat properly for my training) In your own words, what is the biggest frustration you currently have with your nutrition?On a scale of 1-10, how committed are you to making changes to your daily routine for the next 10 weeks? 1 2 3 4 5 6 7 8 9 10 Anything else you think we should know prior to writing your program?Section 5: Nutrition Preferences & HistoryWe don’t do one-size-fits-all. Let’s figure out what approach will actually work for your lifestyle. Which nutrition tracking method do you prefer or have the most experience with? Macro Tracking (Flexible dieting using our app) Structured but Flexible Meal Plan (Tell me exactly what to eat and when – like macros w/ training wheels) Unsure / Let’s discuss on the call How many meals do you realistically prefer to eat per day? 3 main meals 3 main meals + snacks 4-5 smaller meals Other Please shareWhat are your top 5 favourite healthy protein-rich foods?What are your top 5 favourite healthy carbohydrate-rich foods?What are your top 5 favourite healthy fat food sources?What are your top 5 favorite fruits and vegetables?Are there any foods you absolutely hate or refuse to eat?How often do you typically eat out or order takeaway in a standard week? Rarely (0-1 times) Occasionally (2-3 times) Frequently (4+ times) Section 6: Coaching Style & ExpectationsHow can I best coach you to get the result you want? When you face a roadblock or start to fall off track, how do you prefer to be coached? Direct & Blunt: Tell me exactly what I’m doing wrong and how to fix it. No sugar-coating. Supportive & Collaborative: Help me troubleshoot the issue and find a workaround together. Data-Driven: Show me the numbers and the logic so I can understand the ‘why’. In very simple, practical terms, what is it that you need to do to achieve your goals? i.e. what can we do for you?What is the number one thing that has caused you to fail or quit a nutrition program in the past?Section 7: Group Calls & CommunityPPT10 includes 5 bi-weekly group coaching calls. Let’s make them valuable. Call Format: Calls will be hosted live on each week (Mondays 7pm). During these calls, I will cover a specific topic and answer questions submitted via your weekly check-ins. You are invited to attend live, but the audio will be recorded and shared as a private podcast/audio file afterwards so you can listen on your commute or walk. What are the top 2 nutrition topics you want covered during these group calls? (e.g., eating out, alcohol, meal prep, understanding macros, navigating social events)Do you have any specific questions right now that you'd like me to cover in the first group call?