Personal Training Consultation Form
Full Name
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Height (cm)
Weight (kg)
Phone Number
*
-
Area Code
Phone Number
Email
example@example.com
What do you do for a living?
What is the activity level at your job?
None (seated/desk job)
Moderate (Light activity such as walking)
High (Heavy labour, very active)
What is your fitness goal?
Why is this goal important to you? Is there a timeframe?
What do you currently do in terms of exercise? Please explain.
What is your experience in weight lifting?
Do you suffer any of the following:
Diabetes
Previous heart attack
Stroke
Migraine
High blood pressure
Joint pain
Muscle injury
Pregnant/Post partum
Other
If 'Other', please explain.
Are you looking for weekly sessions or only a plan/guidance (online coaching)?
Weekly 1-1 session/s
Online coaching
Not sure yet
What made you fill out this form today?
What are your expectations of a fitness coach?
Submit
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