Online Coaching Consultation Form

Online Coaching Consultation Form
Full Name*

First NameLast Name
MaleFemale
Date of Birth*

MonthDayYear
Phone Number*
Email*
example@example.com
What do you do for a living?
Sedentary(a lot of time seated)Moderate (light activity such as walking)High (heavy labor, very active)
Improved HealthIncreased StrengthIncreased Muscle MassFat LossWeight GainNutrition Guidance
Improve confidenceReduce stressImproved mindsetHelp support mental healthIn control and ready for anything!
What are the reasons for your current goals?

TImeline for achieving your goal.

Rows	12 WKS	16 WKS	24 WKS	32 WKS	40 WKS	1 YEAR
NOW

YesNo
Gym- cardioGym- weightsHome WorkoutsSportOutdoors- hiking, running, cycling
How often are you willing to exercise per week?
YesNo
YesOnly for PT to seeConsent for use on social media (hidden identity).No to all
12345678910
What are your expectations of me as your Personal Trainer?
1.) All the information on this form is correct and to the best of my knowledge. I understand that all the information given will be kept confidential. I am happy to be contacted by NAOMI SLIGHTS FITNESS LTD to organise my free consultation call.
YesNo
Signature*
Thank you for taking the time to fill out this form, I will be in touch to arrange our call.

Naomi
Should be Empty:

Thank you for taking the time to fill out this form, I will be in touch to arrange our call.