Pre Consultation Form

Pre-Consultation Enquiry Form

Thank you for looking to enquire to join my team, I am excited to help you get on your way to achieving your goals. Please fill in this form below with as much detail and honesty as possible. Once completed I will be in contact within 72 hours, Thank you.

Full Name

First NameLast Name

Gender

Other

Age

years

Phone Number

Area CodePhone Number

Email

example@example.com

How long have you been wanting to make changes to your lifestyle?

How important is it for you to achieve these changes? 1=lowest, 10=highest

How would you feel if you achieved these goals?

Have you ever set your own goals before and if so, what were they?

Did you achieve them?

What is your current activity level?

Please list the physical activities that you participate in outside of the gym and outside of work.:

How would you rate your current diet (1 being really needs improvement, 5 doing everything well):

Please rate your readiness for change.

What following goals does best fit in with your goals?

In your words what are the main outcomes you would like to achieve from having personal coaching?

Timeline for achieving your goal.

Rows	3 months	6 months	9 months	12 months +
Please Select

How often are you willing to train a week to reach your goal?

Are you willing to invest a minimum of £50 per week in yourself?

Please rate your motivational level to do what it takes for reach your goal.

Are you currently excersising regulary (at least 3x per week)?

Have you trained with a personal trainer before?

If yes what kind of training did you do:

At what times during the day would you prefer to train?

Are you experiencing any stresses or motivational problems?

When it comes to trying to achieve your goal, what do you feel like you need support with most?

Other

Do you want to add anything else you feel would benefit my understanding of you and what you want to achieve?