Personal Training Consultation Questionnaire

Full Name*

First NameLast Name

Gender

MaleFemalePrefer not to say

Date of Birth*

MonthDayYear

Age*

years

Height

cm

Weight

KG

What do you do for a living?

Whats the activity level at your job?

None (seated only)Moderate (light activity such as walking)High (heavy labor, very active)

Describe your work schedule. Do you follow a regular working schedule, do you work days, afternoon or nights?

How often do you travel?

RarelyA few times a yearA few times a monthWeekly

Please list the physical activities that you participate in regularly:

Please rate your readiness for change.

What following goals does best fit in with your goals?

What is your goal with your training?

Why?

Timeline for achieving your goal.

Rows	8 WKS	16 WKS	24 WKS	32 WKS	40 WKS	1 YEAR
NOW

How often are you willing to train a week to reach your goal?

Please rate your motivational level to do what it takes for reach your goal.

Are you currently excercising regularly (at least 3x per week)?

YesNo

Do you have access to a gym?

YesNoI have home equipmentGym and home equipment

Have you trained with a personal trainer before?

YesNo

If yes what kind of training did you do:

At what times during the day would you prefer to train?

MorningMid-DayAfternoonEvening

How often do you want to do Personal Training a week?

Please Choose

What are your expectations on me as your Trainer and Coach?

1.) CANCELLATIONS:

Cancellations should be made at least 24 hours in advance of a scheduled session. Sessions canceled less than 24 hours in advance will be charged in full to the client unless specified by the trainer. Phone/zoom calls should be canceled at least 30 minutes before the scheduled call. Calls canceled less than 30 minutes before the scheduled time will be given to the trainer to decide on whether a rebooking will occur or not.

2.) LATE ARRIVALS:

Each session shall be 1 hour in length and phone/zoom call times will be semi-flexible depending on discussions and changes. Sessions will not be extended (unless time is available) due to the lateness of the client or due to interruptions caused by the client.

3.) ALL THE INFORMATION I HAVE GIVEN IS CORRECT:

All the information on this form is correct and to the best of my knowledge. I have sought and followed any necessary medical advice. I understand that all the information given will be kept confidential.

I AGREE TO THE ABOVE TERMS & CONDITIONS!*

YesNo