This questionnaire will help us design the best plan for you. Please answer honestly

Este cuestionario nos ayudará a diseñar el mejor plan para ti. Responde con sinceridad.

1. General Information | Información General

First Name *

Last Name *

Email *

Telefono *

Age *

Weight (kg/lb) *

Height (cm/ft) *

2. Main Goal | Objetivo Principal

What do you want to achieve with this program? (Select one or more options)

Lose fat | Perder Grasa

Gain muscle mass | Ganar Masa Muscular

Improve my performance and energy | Mejorar mi rendimiento y energía

Create healthy, sustainable habits | Crear hábitos saludables y sostenibles

Improve my appearance and self‑esteem | Mejora mi imagen y autoestima

Other | Otro

¿Qué quieres lograr con este programa? (Marca una o más opciones)

If you selected “Other,” please specify::

How many pounds/kilos do you want to lose or gain?

How soon do you want to achieve your goals?

3. Commitment Level | Nivel de Compromiso

On a scale of 1 to 10, how committed are you to this transformation? (1 = Not committed at all, 10 = Fully committed)

What motivates you to make this change? (e.g., health, aesthetics, performance, emotional well‑being, etc.)

What obstacles do you think could get in the way of your progress? (e.g., lack of time, discipline, stress, nutrition, etc.)

Have you tried to achieve this goal before?

Yes | Si

No | No

¿Has intentado lograr este objetivo antes?

If you answered “Yes,” what has kept you from reaching your goal in the past? (e.g., lack of consistency, low motivation, poor nutrition, lack of knowledge, etc.)

5. Alimentación y Hábitos | Nutrition and Habits

Are you currently following any nutrition plan?

Yes | Si

No | No

¿Sigues algún plan de alimentación en este momento?

If you answered “Yes,” briefly describe what your current eating looks like:

How many meals do you eat per day on average?

1-2

3-4

5-6

¿Cuántas comidas haces al día en promedio?

Do you frequently eat snacks or treats?

¿Consumes snacks o antojos con frecuencia?

How often do you eat out?

Hardly ever | Casi nunca

1–2 times per week | 1-2 veces por semana

3–5 times per week | 3-5 veces por semana

Every day | Todos los días

¿Qué tan seguido comes fuera de casa?

Do you have any dietary restrictions or food allergies?

¿Do you drink alcohol?

Never | Nunca

Occasionally | Ocasionalmente

Frequently | Frecuentemente

¿Consumes alcohol?

¿Do you drink enough water every day?

Yes | Si

No | No

¿Tomas suficiente agua diariamente?

If you answered “Yes,” how much water do you drink per day?

6. Sueño, Estrés y Bienestar Emocional | Sleep, Stress and Emotional Well‑Being

¿How many hours do you sleep on average each night?

Less than 5 hours | Menos de 5 horas

5-6 hours | 5-6 horas

7-8 hours | 7-8 horas

More than 8 hours | Más de 8 horas

¿Cuántas horas duermes en promedio cada noche?

¿Does stress affect your eating and your results?

Yes | Si

No | No

¿Sientes que el estrés afecta tu alimentación y resultados?

How emotionally balanced do you feel on a scale of 1 to 10? (1 = Very unstable, 10 = Completely at peace)

7. Metafísica y Crecimiento Personal (Opcional) | Metaphysics and Personal Growth (Optional)

¿Are you interested in working with the power of the mind and energy as part of your transformation process?

Yes | Si

No | No

¿Te interesa trabajar el poder de la mente y la energía en tu proceso de transformación?

¿Have you ever practiced visualization, affirmations, or meditation for your physical and emotional well‑being?

Yes | Si

No | No

¿Has practicado alguna vez visualización, afirmaciones o meditaciones para tu bienestar físico y emocional?

8. Plan Personalization | Personalización del Plan

¿What do you expect from me as your coach in this process?

¿Is there anything else I should know to design your plan?

¿Cuando estarías disponible para una llamada rápida?