PERSONAL TRAINING
Consultation Form
The information in this form is required to know a little more about you. To know what your goals are, know what you nutrition is currently like, know what your lifestyle is like. From this we will be able to work on the plan to reach your goals. Please be as honest as you can.
CONTACT DETAILS
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
-
Area Code
Phone Number
Date of Birth
*
/
Day
/
Month
Year
YOUR GOALS
What are your goals you would like LNP Coaching to help you with?
Fat / Weight loss
Gain Size and Strength
General Fitness / Conditioning
Rehabilitation
Flexibility / Mobility
Other
If other please explain below what help you are looking for from LNP Coaching.
Current weight
85kg
Target Weight
80kg
Your goals!
Drop dress size, sub 30min 5k
Your goals!
Drop dress size, sub 30min 5k
Your goals!
Drop dress size, sub 30min 5k
Your goals!
Drop dress size, sub 30min 5k
Any Events coming up?
Holiday, Wedding, 5k
When is it?
6 months / August 2021
What would you like to achieve in 3 Months and why?
Lose a stone, Learn how to exercise with good form.
In 6 months and why?
Run a half marathon, be confident going on holiday.
In a year and why?
Run a marathon, compete in a powerlifting comp
What would prevent you from achieving your goals?
Family responsibilities
Knowledge of fitness
Injuries
Knowledge of food
Fitness
Other
If other please explain below.
Any minor injuries / tightness in muscles?
Tight quads, Tight Shoulders etc
If so how long has this been going on?
Days/ Weeks/ Months
LIFESTYLE AND NUTRITION
Do you smoke?
Yes / No
If so how many a day?
10 / 20...
Do you drink alcohol?
Yes / No
If so how often?
daily/ weekly/ weekends
What type of work do you do?
Sit at a desk, physical - labouring.
Full Time / Part Time?
8 hour day / 12 hour day
How much sleep do you get?
3 hours, 5 hours, 7 hours etc..
FOOD DIARY
Include drinks you have also.
Breakfast
What do you have and at what time?
Snack
What do you have and at what time?
Lunch
What do you have and at what time?
Snack
What do you have and at what time?
Dinner
What do you have and at what time?
Desserts
What do you have and at what time?
Any Food Intolerances
Taking any Supplements
BCAA, Protein shakes, multivitamins etc
LASTLY
Anything else you would like to add which will help us?
Signature
*
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