Date of Birth
Do you currently have an injury, a movement limitation, or pain that limits your ability to exercise? (knees, back, etc.)
If you have any diagnosed health problem, please list the condition (high blood pressure, diabetes, etc.):
What are your primary fitness goals?
How long have you been thinking about accomplishing your fitness goals?
What has prevented you from achieving your goals?
What would happen for you if you achieve your goals?
What specific body parts are you more focused on changing?
On a scale of 1 to 10 (10 being the most serious), how serious are you about accomplishing your fitness goals?
How often are you willing to train per week in order to reach your goal?
Have you ever worked with a personal trainer before?
If you are employed, how would you describe your activity at work?
What can we do in order to make sure that you are successful?
At what times during the day would you prefer to train?
How many meals are you eating daily?
What is your biggest nutritional challenge?
Eating out frequently
Time to prep meals
Not knowing what to eat
How many times per week do you eat out?
1 to 3
4 to 6
Does your spouse or family support your health and fitness journey?
Are there any specific events coming up that will help us motivate you to reach your goals?
Should be Empty: