Online Coaching Form
Please fill out this form so we can have a better understanding of your goals and tailor your programme accordingly
Date Of Birth
Weight and Height
What are your goals from using our training programme and nutrition advice?
Fat loss / ‘Toning’
Gain muscle mass
Sports specific training ie for netball, football etc
Pre/Post Natal training
Improve cardiovascular fitness
Bodybuilding Show Prep
General health and well-being
Other (Please specify...)
You may choose more than one
How many days per week will you be training?
Make sure this is a realistic number around your lifestyle and work etc
How many minutes do you have to train per session?
What days per week will you be training?
How would you describe your work?
How often would you estimate you reach 10,000 steps per day?
Not very often
Most of the time
I don’t know
Please state any medical conditions or injuries we may need to know about when designing your exercise programme. Also state any dietary requirements / allergies.
Do you have a gym membership?
If yes, which gym are you a member of?
If training from home, what equipment do you have available? (If any)
What is your preferred training split? (Upper/Lower? Push/Pull/Legs? Full Body?) If you are not sure, leave blank and we will decide which is best according to your goal
Do you know any of your one rep maxes or working weight for certain exercises? If so, please state as many as you remember. Leave blank if unsure.
How would you describe your diet currently?
Up and down
Are you currently following any of these diets?
Any form of fasting
Juices / Detoxing supplements
If other, please state
How would you describe your eating habits? Are they consistent? How many meals you do generally eat per day? Give as much detail as possible
If you’re currently tracking, how many calories are you on per day what’s your macro split?
Leave blank if you’re not sure what this means or are not currently tracking
How many hours sleep would you say you have on average per night?
Are you happy to receive regular check-ins?
Are you happy for us to be in touch using the personal details you have provided?
Add a ‘before’ photo. This is important to track your progress throughout the programme if your goals are aesthetic
I understand that the testing undertaken and exercises performed as part of this programme can be physically demanding and that the health screening questionnaire is designed to help me in assessing my fitness for this programme. As a condition of my participation I accept full and complete responsibility for my participation in this programme of personal training and, where I have any doubts about my fitness, I have obtained medical approval for my participation. I agree that Emily Killick and Embody Training is/are free of all and any liability for any death, injury, illness or other problems consequent on, or subsequent to, my participation in any training programme or nutrition advice. Please sign below
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