New Client Application:
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Date of Birth
-
Month
-
Day
Year
Date
Current Occupation
What type of training are you interested in?
1 on 1 in person Training
Group Training
Online Training
Availability for in person training (mornings, evenings, time, etc.)
How many days are you looking to train a week?
2
3
4
5
Do you have any medical conditions or injuries?
What are your current goals? (Be specific, lose 10-20lbs , gain muscle mass, be more active, inspire others)
What do you feel is stopping you from reaching these goals? (Money, confidence, no support, etc)
On a scale of 1-10 , 1 being “I’m satisfied where I am” and 10 being “I need help now and am willing to do what it takes to reach my goals” how do you rate your level of dedication?
What expectations do you have for me as your coach/trainer if we decided to continue this journey together? (Please be specific.)
Does your partner or spouse support your goals and desires to partner with a personal trainer?
Yes
No
Haven’t talked about it
They are uncomfortable
If accepted how soon would you like to get started? (If you aren’t ready no worries, please wait and resubmit when you are. I am going to be giving my all to those who are trying to take action and feel confident in making in an investment in themselves as we move forward. This is something I take very serious as I hope you would as well)
Any other thoughts, questions, comments, or concerns?
Submit
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