JadeFitness Personal Training Intake Form

JadeFitness

Personal Training Enquiry Form
Full Name

First NameLast Name
Date of Birth

MonthDayYear
Phone Number

Area CodePhone Number
Height
ft
Weight [If known]
kg
Email
Instagram Handle
What do you do for a living?
Do you follow a regular working schedule? [days, afternoons, nights]
What's the activity level at your job?
What's your overall daily activity level?

1

2

3

4

5

1 is None, 5 is High
Please list the physical activities you participate in outside of the gym and work:
What are your current health and fitness goals? [Please go into detail]
Why is it important to you that you achieve these goals?
What has prevented you from achieving these goals previously?

Timeline for achieving your goals:

Rows	3 months	3-6 months	6 months - 1 year	No timeline goal
Timeline

Have you exercised in the past? If yes, please detail your previous routine:
Do you currently exercise? If yes, please detail your routine:
Please detail what your current diet looks like [on an average day/week]:
Have you ever tracked your nutrition before?
Have you had a PT before?
How many sessions would you like per week?
On what days would you like personal training?
At what times would you like personal training?
Is it okay for me to post photos/videos of your training/progress photos on social media?
Are you comfortable taking progress photos?
What are your expectations of me as your PT?
Please rate your readiness to change.

1

2

3

4

5

1 is Low, 5 is High
Terms and conditions:

1.) CANCELLATIONS - Cancellations should be made at least 24 hours in advance of a scheduled session.

2.) RESCHEDULING SESSIONS - Missed sessions will be rescheduled if possible.

3.) LATE ARRIVALS - Each session lasts for 1 hour. Sessions will not be extended due to the lateness of the client, or due to interruptions caused by the client.

4.) ALL THE INFORMATION I HAVE GIVEN IS CORRECT - All the information on this form is correct and to the best of my knowledge. I understand that all the information given will be kept confidential.
I AGREE TO THE ABOVE TERMS AND CONDITIONS
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