Full Name
First Name
Last Name
CoachedbyJessicaLauren
Online coaching
Gender
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Year
Age
years
Height
cm
Weight
KG
How had any previous experience with training?
Nope I'm new to training!
I train occasionally
I train regularly
Other
Do you have any medical conditions or injuries ? If so please give details
Please list:
Are you a current smoker?
Yes
No
Your current diet could be best described 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
What are your primary fitness goals?
Improve overall health and wellbeing
Gaining weight
Increase strength
Building muscle
Fat loss
Losing weight
More specifically what is your goal with your training?
How often are you willing to train per week to reach your goal?
Tell me about your current lifestyle/job
Rows
Very frequently
Sometimes
Rarely
Never
Travelling
Stressful tasks
Being active
Are you currently exercising regularly (at least 3x per week)?
Yes
No
Have you trained with a personal trainer before?
Yes
No
What is your preferred training environment?
Gym
Home
Outdoors
How often do you want to train per week?
Please Select
1 Session
2 Sessions
3 Sessions
4 Sessions
5 Sessions
6 Sessions
7 Sessions
Please Choose
How long would you like your training sessions to be ideally?
Please Select
Less than an hour
1 hour or more
No specific time frame
Do you have any specific exercise likes or dislikes?
Feel free to provide some current phsyique pictures
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Phone Number
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Area code (+44)
Phone Number
Email
example@example.com
I'm ready to start sign me up!
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I would like to arrange a consultation call
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