Connor Brennan- PT Consultation

This form is for me to get to know you a little better, looking at what your goals are and what you are wanting to achieve by training with me. It will also give you the opportunity to describe your lifestyle and and any potential restraints that may affect your training and a small food diary to give an insight into your eating habits. All of this information will help me get a clear picture on how to start planning the next steps in helping you achieve your goals.

Name

First NameLast Name

Email

Phone Number

Date of Birth

What are you looking to get out of your training with me?

If you ticked 'Other' please specify below

What are your 3 main goals you would like to achieve?

Current weight (Kg / Stone)

Target Weight (Kg / Stone)

What would prevent you from achieving your goals?

If you ticked 'Other' please specify below

Any minor injuries / tightness in muscles?

If so how long has this been going on?

Do you smoke?

If so how many a day?

Do you drink alcohol?

If so how often?

What type of work do you do?

Full Time / Part Time? (Average hours per week)

How much sleep do you get?

Breakfast - Give a few examples and at what time you are having this meal

Snack - Give a few examples and at what time you are having this meal

Lunch - Give a few examples and at what time you are having this meal

Snack - Give a few examples and at what time you are having this meal

Dinner - Give a few examples and at what time you are having this meal

Desserts - Give a few examples and at what time you are having this meal

Any Food Intolerances or Allergies

Any Supplements - (BCAA, Protein, Creatine, Glutamine, Multivitamins)

Anything else you would like to add which will help us?

Signature: I consent to all of the information provided within this form to be accurate to the best of my knowledge.