Personal Training Application
Personal information
What's your name?
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First Name
Last Name
E-mail
*
example@example.com
Phone number
*
When is your birthday?
Please select a month
January
February
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Month
Please select a day
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Day
Please select a year
2026
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Year
Height in cm or ft?
Weight in kg or lbs?
What do you currently do for work? How physically active are you while at work?
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How many steps per day are you making?
*
Lifestyle information
Do you currently have any diagnosed medical conditions which may/will affect your ability to exercise/achieve results? (insulin resistance, diabetes, high blood pressure etc)
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Do you have any specific dietary requirement? (vegetarian, vegan, allergies, intolerances etc)
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What are you currently eating daily? How many meals per day? Do you cook your food or do you eat out?
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List any dietary restrictions, intolerances, current favorite meals, etc.
How many hours on average you sleep every night?
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How many coffee’s you are having a day?
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Do you smoke? (If so how many)
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Do you drink alcohol? If yes, how many nights per week?
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How much water are you currently consuming per day in litres?
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Do you currently have/or had in the past any of the following injuries that I should be aware of?
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Arthritis
Head/ neck injury
Shoulder injury
Arm injury
Wrist injury
Upper Back injury
Lower Back Injury
Hip/Pelvis Injury
Knee/ Thigh/ Hamstring Injury
Ankle/Foot Injury
N/A
Training
Please explain what have you been doing training wise over this past year?
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What is your current training look like right now? Are you following any structured programme?
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Are you doing any other form of exercise/activity away from the gym such as a sport/running club/rowing club etc? If yes, please list everything you do and how often is that.
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How many days per week can you definitely commit to training?
*
What are you looking to achieve? Why now and what is preventing you from achieving this?
*
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