Personalized Programming Questionnaire

I assume you’ve been given a clean bill of health and are healthy and able to resistance train. If you have been told by a doctor or a physical therapist that you should not be lifting weights, or if you have a condition that prevents you from safely lifting weights, then I am unable to do your programming.

Name*

First Last

Email*

Gender*

male
female

Height*

Weight*

Please agree to the terms and conditions of the bretcontreras.com website and Personalized Programming with the Glute Guy before proceeding:*

Disclaimer:

The Personalized Programming product is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this Site.

If you think you may have a medical emergency, call your doctor or 911 immediately. Bret Contreras does not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned on this Site.

Reliance on any information provided by Bret Contreras, BretContreras.com employees, others appearing on this Site at the invitation of Bret Contreras, or other visitors to this Site is solely at your own risk. Results with this program may vary. Exercise and proper diet are necessary to achieve and maintain weight loss. Consult your healthcare professional before beginning any diet or fitness regimen and please refer to your healthcare professional with any medical related questions that may arise while training with the Bret Contreras Personalized Programming Product.

This product may be discontinued at any time for any reason.

Yes, I agree to these terms and conditions.

No, I do not agree to these terms and conditions.

Do you have any health conditions or injuries that I need to be aware of?*

Yes

No

Please describe these conditions or injuries below:

What is your primary training goal?*

physique improvements

strength gains

general health

functional improvements

Are you a bikini, figure, or powerlifting competitor?*

yes

no

Are you prepping for a show or meet?*

yes

no

Please specify what you are prepping for below.*

bikini Competition

figure Competition

powerlifting Meet

When is the show or meet?*

Do you want to train glutes only or would you like for me to create total body programming? If you prefer that I create programming for your glutes only then choose the glutes only option. If you would like for me to create total body programming that targets glutes as well as your entire body, please pick total body programming. We will discuss training preferences in the next question.*

total body programming (glutes, as well as upper body, lower body)

lower body

glutes only

Do you have a preferred type of training split?*
I prefer full body workouts, but I’ve performed and programmed body part splits, upper/lower, push/pull, and more, and can make any of those work.

full body workouts

upper/lower split

push/pull split

Is this the training pattern you would like to continue to follow?

Yes, please keep my training split the same.

No, I am open to whatever you think is best.

How many days a week do you want to train?*
If you want my direction on this, I believe that 3-5 days a week is optimal and can make any of those work. However, some people can only fit in 2 days a week, and that’s infinitely better than 0 times per week.

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2

3

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5

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7

Do you have time constraints on any of your training days?*

I have 30 minutes available

I have 1 hour available

I have unlimited time available

Where will you be training?*

commercial gym

private studio

home gym

Please check the equipment you have access to:*
barbells
dumbbells
cable column
flat bench only
benches from different angles (flat, incline, overhead)
equipment to perform barbell hip thrust (low bench, aerobic step, Hip Thruster, etc.)
45-degree hyperextension
smith machine
chin-up bar
lat pulldown machine
chest-supported row machine
inverted row apparatus (suspension straps, smith machine, equalizer)
lying leg curl machine
seated hip abduction machine
glute ham developer
trap bar
leg press
long resistance bands
minibands or Hip Circle

Are there any exercises or methods that you absolutely love or would like to get better at and want in your program?*

yes

no

Please be specific and list these exercises or methods below.*

Are there any exercises or methods you do not enjoy performing or consistently cause pain and/or injury that you would prefer not to have in your program?

yes

no

Please list the exercises you do not want included your program.

Please provide a brief overview of your prior training experiences, particularly what you’ve been up to over the last six months.*

Please check which compound lifts you have experience with:*
barbell back squat
barbell front squat
barbell deadlift
barbell hip thrust
barbell bench press
barbell military press

What is your normal daily activity level?*

Sedentary: Spend most of the day sitting (e.g. desk job)

Lightly Active: Spend a good part of the day on your feet (e.g. teacher, salesperson)

Active: Spend a good part of the day doing some physical activity (e.g. food server, postal carrier)

Very Active: Spend most of the day doing heavy physical activity (e.g. bike messenger, carpenter)

How many push-ups can you perform with good to excellent form?*

How many chin-ups can you perform with good to excellent form?*

Is there any other information you deem relevant that may affect your training program?

OPTIONAL: Please upload a current FRONT, SIDE, and/or BACK full body photo.

Drop files here or

Max. file size: 20 MB, Max. files: 3.

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Personalized Programming Questionnaire

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