Architecte Corps
Private Transformation
Client Questionnaire
Confidential assessment · Private coaching & nutrition
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ខ្មែរ
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Client ID
—
Personal Information
Full Name *
Age *
Occupation
Height (cm)
Current Weight (kg)
WhatsApp Number *
Email
Instagram
Body & Transformation Goals
Main Goals (select all that apply)
Build muscle
Gain healthy weight
Improve body shape
Increase strength
Improve posture
Nutrition coaching
Confidence & lifestyle
Areas to improve (select all that apply)
Glutes
Legs
Waistline
Arms
Back
Shoulders
Chest / Pectoral
Describe your dream physique
Training History
Experience level
Beginner
Intermediate
Advanced
Currently training?
Yes
No
Sessions per week
Worked with a coach before?
Yes
No
Injuries or physical limitations
Nutrition & Lifestyle
Current eating habits
Meals per day
Struggle to eat enough food?
Yes
No
Skip meals often?
Yes
No
Water intake per day
< 1L
1–2L
2–3L
> 3L
Average sleep per night
< 5h
5–6h
7–8h
8h+
Health & Medical
Medical conditions or chronic illnesses?
Yes
No
If yes, please explain
Allergies or food intolerances?
Yes
No
If yes, specify
Currently taking medication or supplements?
Yes
No
If yes, please list medication / supplements
Have you experienced (select all that apply)
Back pain
Knee pain
Shoulder pain
Dizziness
Hormonal imbalance
Breathing difficulties
Mindset & Commitment
What has stopped you from achieving your goals in the past?
Commitment level (1–10)
1 — Not sure
10 — All in
7
How would transforming your body change your life?
Submit Assessment
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