Client Consultation Form

Client Consultation Form
Personal Data:

First NameLast Name
Address

Street Address

Street Address Line 2

CityCounty

Postcode
Email
example@example.com
Phone Number

Area CodePhone Number
Emergency Contact
First and Last NameRelationship
Phone Number

Area CodePhone Number
Static Measurements
Weight(kg):
Height(cm):
Waist(cm):
Thigh(cm):
Arm(cm):
I consent to provide weekly body images on my check-in days
Health and Wellbeing
When was the last time you saw a GP?
What is your current health like?
Do you have a tendency to lose, gain or maintain weight?
Do you have any present injuries?
On a scale from 1 to 10 how do you feel mentally? (1 being very poor, 10 excellent)
On a scale from 1 to 10 how do you feel physically? (1 being very poor, 10 excellent)
Medical History
Are you pregnant or recently given birth?
Do you have any medical conditions?
Are you currently on any medication?
Do you suffer with any allergies?
Have you had any surgeries/recently been hospitalised?
If you've answered 'Yes' to any of the above, please state below:
Nutrition
Do you track your food/count macros?
If you've answered 'Yes' please state below:
Are you allergic to any food?
If you've answered 'Yes' please state below:
What are your favourite types of food?
Are there any foods you dislike/can't eat due to medical reasons?
Work and Lifestyle
What is your occupation?
How many hours do you work per week?
On average, how many hours of sleep do you get per night?
Training
How long is your average workout session? (hours/minutes per sesh)
How many times a week do you train?
Where do you workout?
Where do you prefer working out?
Goals/Objectives
What are your main goals?
Do you have any training preferences?
Is there anything you dislike when training? (e.g. certain exercises or a style of training?)
Disclaimer
I Your Name certify and acknowledge that I have read and understood the questionnaire/consultation form and confirm that all of the details above are true and to the best of my knowledge. I am signing this PAR-Q/consultation form at my own risk and I take full responsibility, as I understand that physical exercise carries risks. Therefore I hereby waive any right or cause of action against Vigorous Fitness from any liability to illness, injury, claim, cost or damage expense, which I or anyone on my behalf may become subject to as a result of my participation in physical training. I will follow all the instructions that my coach/personal trainer will instruct me with and if any of the exercises are not suitable for me I will inform my coach/personal trainer about it. I fully understand the qualifications held by Vigorous Fitness and what they specialise in, that their advice is hypothetical/advisory and not medical or nutritional profession. I also understand and acknowledge that Vigorous Fitness doesn't offer refunds. Therefore once I have paid for the services, it is non-refundable. Any questions I had were answered to my full satisfaction.
Name

First NameLast Name
Signature
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Client Consultation Form

Emergency Contact

Static Measurements

Health and Wellbeing

Medical History

Nutrition

Work and Lifestyle

Training

Goals/Objectives

Disclaimer