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FitCru Health Questionnaire
fitcru Health Questionnaire
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- CONTACT DETAIL
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Account Name
Name
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Email
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Whatsapp no
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Instagram Handle
Gender
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Male
Female
Date of Birth
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DD slash MM slash YYYY
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Age
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What is your height (in cms)
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What is your waist? (It should be measured around the naval in inches)
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What is your neck size (in inches)
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What is your Hips size (in inches)
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What is your current weight (in kgs)
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What is your goal body weight (in kgs)
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Medical Conditions
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High blood pressure
Diabetes
Hypothyroidism
PCOS
None
Other
Tell us more
What is your primary goal?
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Lose Fat
Build Muscle
Athletic Performance
Postpartum Fitness
Get Toned & Shredded
How fast do you want to reach your goal weight?
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Normal pace (not too intense)
A little quicker (ideal for most people)
Super quick (for people with tremendous will power)
What are your dietary preferences?
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Vegetarian
Non Vegetarian
Vegan
Eggetarian
Jain
Pescatarian
Select Your Cuisine Preference
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Indian (regular daal chawal kind of food)
American (burgers, hot dogs , diner kind of food)
Italian (pizzas & pasta)
Mexican (tacos & enchilada)
South Indian (idlis, dosas, uttapam)
Chinese (fried rice and noodles with simple gravy)
sushi
Lebanese (hummus, falafels)
Fast food (low fat junk )
Dessert (both low Cal and high Cal)
All of the above
Other
Please select your preferred style of nutrition
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Low carb
Balanced
Low fat
Ketogenic
Intermittent fasting
Volumetric/ (big portions of low cal food)
Mediterranean(more veggies)
What are your dietary allergies/dislikes etc? Things you do not want as a part of your diet.
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PORK
SEA FOOD
NUT
RED MEAT
LACTOSE
GLUTEN
SUGAR
SOY
EGG
SHELL FISH
ALCOHOL
ONION
GARLIC
Other
None
Please list all foods separated by a space
*
How active are you
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Barely active (0-4k steps / day)
Little active (4-8k steps / day)
Active (8-12k steps / day)
Very active (12-16k steps / day)
Hyper active(16k+/day)
How often would you like to work out
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Below average- 1x week
Trying 2x week
Average 3-4x week
Athlete level 5-6x week
Crazy 7+x week
Experience with workouts
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Beginner
Intermediate
Advanced
What equipment do you have access to?
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Full Gym
DB & Mat
Home based
Bands & Resistance ropes
TRX
Body Weight
Kettlebell
Calisthenics
Bosu
Other
What kind of workouts excite you?
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YOGA
ANIMAL FLOW
BODY WEIGHT
KICK BOXING
ZUMBA
LISS
CROSSFIT
HIIT
COMPUND
ISOLATION
UNILATERAL
STEADY STATE
NEAT
CARDIO
GYM
DANCE
How many meals a day do you consume?
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1
2
3
4
5
Select the time closest to your first meal of the day
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5:00 AM
5:30 AM
6:00 AM
6:30 AM
7:00 AM
7:30 AM
8:00 AM
8:30 AM
9:00 AM
9:30 AM
10:00 AM
10:30 AM
11:00 AM
11:30 AM
12:00 PM
12:30 PM
1:00 PM
1:30 PM
2:00 PM
2:30 PM
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3:30 PM
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4:30 PM
5:00 PM
5:30 PM
6:00 PM
6:30 PM
7:00 PM
7:30 PM
8:00 PM
8:30 PM
9:00 PM
9:30 PM
10:00 PM
10:30 PM
11:00 PM
11:30 PM
12:00 AM
Select the time closest to your second meal of the day
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5:00 AM
5:30 AM
6:00 AM
6:30 AM
7:00 AM
7:30 AM
8:00 AM
8:30 AM
9:00 AM
9:30 AM
10:00 AM
10:30 AM
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11:30 AM
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4:30 PM
5:00 PM
5:30 PM
6:00 PM
6:30 PM
7:00 PM
7:30 PM
8:00 PM
8:30 PM
9:00 PM
9:30 PM
10:00 PM
10:30 PM
11:00 PM
11:30 PM
12:00 AM
Select the time closest to your third meal of the day
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5:00 AM
5:30 AM
6:00 AM
6:30 AM
7:00 AM
7:30 AM
8:00 AM
8:30 AM
9:00 AM
9:30 AM
10:00 AM
10:30 AM
11:00 AM
11:30 AM
12:00 PM
12:30 PM
1:00 PM
1:30 PM
2:00 PM
2:30 PM
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3:30 PM
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4:30 PM
5:00 PM
5:30 PM
6:00 PM
6:30 PM
7:00 PM
7:30 PM
8:00 PM
8:30 PM
9:00 PM
9:30 PM
10:00 PM
10:30 PM
11:00 PM
11:30 PM
12:00 AM
Select the time closest to your fourth meal of the day
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5:00 AM
5:30 AM
6:00 AM
6:30 AM
7:00 AM
7:30 AM
8:00 AM
8:30 AM
9:00 AM
9:30 AM
10:00 AM
10:30 AM
11:00 AM
11:30 AM
12:00 PM
12:30 PM
1:00 PM
1:30 PM
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2:30 PM
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4:30 PM
5:00 PM
5:30 PM
6:00 PM
6:30 PM
7:00 PM
7:30 PM
8:00 PM
8:30 PM
9:00 PM
9:30 PM
10:00 PM
10:30 PM
11:00 PM
11:30 PM
12:00 AM
Select the time closest to your fifth meal of the day
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5:00 AM
5:30 AM
6:00 AM
6:30 AM
7:00 AM
7:30 AM
8:00 AM
8:30 AM
9:00 AM
9:30 AM
10:00 AM
10:30 AM
11:00 AM
11:30 AM
12:00 PM
12:30 PM
1:00 PM
1:30 PM
2:00 PM
2:30 PM
3:00 PM
3:30 PM
4:00 PM
4:30 PM
5:00 PM
5:30 PM
6:00 PM
6:30 PM
7:00 PM
7:30 PM
8:00 PM
8:30 PM
9:00 PM
9:30 PM
10:00 PM
10:30 PM
11:00 PM
11:30 PM
12:00 AM
Please complete the following - “When it comes to my health and fitness , I want to …….
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Please complete the following in continuation to the above - “ because …. “
*
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Weight (in lbs)
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Height (in inches)
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BMI
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Body fat percentage (Male)
(1.2*)+(0.23*B22)-16.2
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Body fat percentage (female)
(1.2*{BMI:110})+(0.23*{Age:116})-5.4
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Fat free mass/ Lean Body mass (Men)
B6*(1-(B40*0.01))
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Fat free mass/ Lean Body mass (Female)
B6*(1-(B40*0.01))
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BMR(Men)
(66.47)+(13.75*B6)+(5.003*B7)-(6.755*B22)
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BMR(Female)
(655.1)+(19.563*weight)+(1.85*height)-(4.676*age)
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TDEE (Male)
BRM(men)*(Activity+Exercise )
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TDEE (Female)
BRM(female)*(Activity+Exercise )
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