Personal Training Consultation

1

Full Name* This field is required.

First Name

Last Name

2

Email* This field is required.

3

Phone number * This field is required.

4

Gender* This field is required.

Male

Female

5

Age* This field is required.

years

6

Height* This field is required.

Ft’in

7

Weight Now / Goal Weight* This field is required.

Lbs

8

Your current diet could be best characterized as:* This field is required.

low-fat

low-carb

high-protein

Vegetarian/Vegan

No special diet

9

What following goals does best fit in with your goals?* This field is required.Choose as many needed

Improved health

Improved endurance

Increased strength\Tone

Increased muscle mass/Tone

Weight/Fat loss/Tone

Weight gain/Tone

Gym Consistency

10

Which Training Option are you interested in ?

In Person Training ONLY

Online Training ONLY

11

Have you trained with a personal trainer before?* This field is required.

Yes

No

12

At what times during the day would you prefer to train?* This field is required.

Morning

Mid-Day

Afternoon

Evening

13

What are your expectations on me as your Personal Trainer?* This field is required.

14

Training Start Date

Date

15

Do you mind being recorded, being on camera ?For training purposes. Keeping up with the progress.

YESNO