Personal Training Inquiry Form

1

Full Name

First Name

Last Name

2

Phone Number

Please enter a valid phone number.

3

Email Address

example@example.com

4

What is your age and occupation?This helps me understand what you’re doing with your body for a large portion of your time (E.g. sitting, standing, physical labour)

5

What is your current height and weight?This information will allow me to determine your daily calorie expenditure as well as how many calories and how much protein you need a day.

6

Have you had any previous injuries? If so what were they? Please be as descriptive as possible.This information lets me know if there are any movements that should be avoided as well as how I can help you to move better to avoid future injury.

7

Do you currently experience any joint pain or pain of any kind? If so where? Is it made worse with any movement?This information will give me an idea of any potential areas of focus as well as what your physical limitations may be, if any.

8

Please explain in detail what you’d like to achieve working with me.This helps me get an idea about how I can best help you and meet your needs. (E.g. lose weight, build muscle, improve nutrition, reduce pain).

9

How long have you been previously attempting to achieve these things? What are the biggest things that have prevented you from being successful?This information will help me identify potential areas of focus so I can better help you effectively reach your goals. (E.g. consistency, motivation, finding time in the day,

10

How comfortable are you in a gym setting?With this information, I can build a customized program, not only tailored around your goals, but your comfortability level in the gym.

Very Uncomfortable

Slightly Comfortable

Comfortable

Very Comfortable

11

How would you describe your current nutrition habits?This gives me an idea of how you’re currently eating as nutrition plays a big role in health and fitness. (E.g. how many meals do you eat a day, what types of food do you mostly eat, how often do you snack and on what?)

12

What day and time work best for a free consultation?Click on the date to select a date and time or use the arrows to switch through days.

13

Choose a second available timePlease choose a different day for a consultation in case I am not available on the first selected date.