Full Name
*
First Name
Last Name
Phone #
Gender
Male
Female
Instagram
Height
cm
Weight
KG
What do you do for a living?
If you have any diagnosed health problems list the condition(s).
Are you experiencing any stresses or motivational problems?
Yes
No
What following goals does best fit in with your goals?
Improved health
Improved endurance
Increased strength
Increased muscle mass
Fat loss
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.
1
2
3
4
5
6
7
8
9
10
Have you trained with a personal trainer before?
Yes
No
At what times during the day would you prefer to train?
Morning
Mid-Day
Afternoon
Evening
What are your expectations on me as your Personal Trainer?
Submit
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