TRAIN With NAELSKI
P E R S O N A L T R A I N I N G
Full Name
*
First Name
Last Name
Gender
*
Male
Female
Are you on birth control ?
Yes
No
Date of Birth
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
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5
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31
Day
Please select a year
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
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1924
1923
1922
1921
1920
Year
Age
*
years
Height
cm
Weight
*
KG
City Located In
*
Instagram Handle
*
What’a your current activity level?
*
None
Moderate
High
What following goals does best fit in with your goals?
*
Improved health
Improved endurance
Increased strength
Increased muscle mass
Fat loss
Current goal ?
*
What is a fitness goal you would like to accomplish the year ?
*
What is holding you back from your goals(s) ?
*
What is motivating you to start?
*
If you have any injuries, please list them.
*
Do you suffer from diabetes, asthma, high or low blood pressure?
*
Yes
No
Please list:
Are you a current cigarette smoker?
*
Yes
No
Your current diet could be best characterized as:
low-fat
low-carb
high-protein
Vegetarian/Vegan
No special diet
Please rate your readiness for change.
*
1
2
3
4
5
6
7
8
9
10
How often are you willing to train a week to reach your goal?
*
Are you currently excersising regulary (at least 3x per week)?
Yes
No
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
How often do you want to do Personal Training a week?
*
Please Select
1 Session
2 Sessions
3 Sessions
4 Sessions
5 Sessions
6 Sessions
7 Sessions
Please Choose
What type of sessions are you interested in?
*
1 on 1 ( Just you and me. )
Buddy ( You Bring A Friend )
Group ( I select 2-4 to train along you. )
ONLINE COACHING
What’s a your weekly training budget?
*
What are your expectations on me as your Personal Trainer?
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