Personal Training Consultation Questionnaire
  • Personal Training Consultation Form

    Personal Training Consultation Form

  • Gender
  • Whats the activity level at your job?
  • Do you have or have you had in the past any of the following:*

  • Does your physician know you are participating in this exercise program?*

  • Has anyone of your immediate family developed heart disease before the age of 60?*
  • Do you suffer from diabetes, asthma, high or low blood pressure?*
  • Are you a current cigarette smoker?*
  • Your current diet could be best characterized as:

  • Please rate your readiness for change with 1 being not ready to change and 10 being one-hundred percent (100%) ready to change.
  • What categories best fit in with your goals?

  • Rows
  • Are you currently exercising regularly (at least 3X per week)?

  • Have you trained with a personal trainer before?
  • At what times during the day would you prefer to train?
  • ***For Virtual Training Only.*** What workout equipment do you have at home.

  • How would you like to have your consultation?*

  • 1.) CANCELLATIONS

    Cancellations should be made at least 24 hours in advance of a scheduled session. Sessions cancelled less than 24 hours in advance will be charged in full to the client.

    2.) LATE ARRIVALS

    Sessions will not be extended (unless time is available) due to the lateness of the client or due to interruptions caused by the client.

    3.) ALL THE INFORMATION I HAVE GIVEN IS CORRECT

    All the information on this form is correct and to the best of my knowledge. I have sought and followed any necessary medical advice. I understand that all the information given will be kept confidential.

  • I AGREE TO THE ABOVE TERMS & CONDITIONS!*
  • Date*
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  • Should be Empty: