Full Name
*
Phone Number
*
-
Area Code
Phone Number
Age
*
years
Instagram
*
Email Address
*
Location
*
City and State
What is your height ?
Ex. 5’9”
What is your weight?
Lbs
What do you do for a living?
*
Who referred you?
*
What are your fitness goals?
Weight Loss
Weight Gain
Build Lean muscle mass
Lower Body fat %
How many times per week do you currently workout?
None
1-2
3-4
5+
Describe your fitness progress thus far
1- Poor (little to no progress)
2- Struggling ( some progress, but not fast enough
3- Successful (Nice progress, but looking for more improvement
If you could start making real results towards your fitness goals, will you comply with my recommendations?
YES
NO
Have you trained with a personal trainer before?
Yes
No
What is your biggest struggle or challenge when it comes to fitness and working out ?
How much are you willing to invest per month on your goals ?
*
Are you willing to invest up to $925 per month to improve your health and fitness?
*
Yes
No
Are you able to travel to Fort Lee, NJ 2-3 times per week?
*
Yes
No
List all minor and major injuries that may limit your ability to exercise :
N/A if not app;icable
Do you currently have any health conditions that we should know about (Please include those that may interfere with exercise or nutrition (Such as asthma, high or low blood pressure etc)
Do you prefer female or male trainer?
Female
Male
Doesn’t Matter
What time of day do you prefer to train with us?
*
Mornings
Afternoons
Evenings
Flexible
Is there anything else you would like to add to your application?
Submit
Should be Empty: