Training inquiry
Set the pace
Name
First Name
Last Name
Date of birth
-
Month
-
Day
Year
Date
What is your active status?
Please Select
Fairly active
Extremely active
When I’m motivated
Not so much
I’m lazy
Please chose what best describes you the most
How physically active are you?
Train 4+ days per week
Play sport a few times per week
Train 2-3 days per week
Sedentary
Other
What do you need help with the most?
Weight loss
Weight gain
Increase muscle mass
Form and technique
Increase strength
Increase flexibility
Nutrition
Other
What is your main goal you want to achieve? And do you have a timeframe in which u want to achieve this goal?
Please go into as much detail as you can
How determined are you to make a change?
1
2
3
4
5
What has stopped you from taking action?
I work long hour's
Financial issues
I struggle staying motivated
Busy lifestyle
I get embarrassed in the gym
Other
Have you followed a training program before?
Yes
No
Would you prefer…
Face to face personal training
Online coaching
Do you have any injuries or medical issues i should know about?
Do you have a question for me?
Contact details
Phone Number
Please enter a valid phone number if you would like me to contact you
Format: (000) 000-0000.
Email
Please enter a valid email address.
Submit
Should be Empty: