Liam Sarkezi
CoachLiamfit /pre screening
Name of the Individual
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
1. Gender
Male
Female
2. Have you trained at a gym before?
Yes
No
3. Would you be interested in a customised training program?
Yes (tell me more)
No ( I like my training)
Are you interested in Face to Face training sessions?
Yes
No
4. What are you Goals in terms of training?
5. What is your current weight?
7. Which category would you be more interested in?
Building muscle
Lose bodyfat/weight
Fixing technique/form
6. Do you have a goal weight you want to be at?
Idc about weight
Yes (what goal weight down below)
Other
9. Would you seek into 1on1 personal training?
Yes
No
8. How many times a week do you train?
1
2
3
4
5
6
10. Do you currently smoke?
Yes
No
11. How active is your work?
Very busy always on my feet
Busy
Moderate
Not active at all
12. Any medical conditions or concerns I need to know of?
No
Yes - right below what the condition or concern is.
Other
13. Any injuries I need to know about
No
Yes - Below explain what injuries
Other
14. What type of training are you interested in?
Powerlifting/strength training
Hypertrophy/resistance training
Home workouts
Functional fitness
Boxing/cardio
Just overall health & fitness
15. How confident are you in your training?
Very confident
Go alright could improve
Little shy but not to bad
Got no idea
Submit
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