DOUBLE C PT
CONSULTATION FORM:
Name
First Name
Last Name
Date of birth
-
Day
-
Month
Year
Date
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: 0000000000.
Any current or previous medical conditions, illness' or injuries that may impact your ability to exercise?
What are you hoping to achieve through coaching?
(e.g. fat loss, muscle gain, confidence, consistency, performance)
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Why is this important to you right now?
What’s made you enquire at this point? be honest!
How would you describe your gym experience?
Beginner (new or unsure what to do)
Intermediate (some experience, inconsistent results)
Advanced (confident but stuck or plateaued)
How many days per week can you realistically train?
2 days
3 days
4 days
5 days
Any exercises you like or dislike?
Anything in your lifestyle that usually makes consistency hard?
(e.g. work hours, motivation, stress, travel, food choices)
How often are you wanting to attend the gym? which days and what times during the day are you planning on attending the gym?
What do you feel has held you back in the past?
Lack of structure
Motivation / accountability
Nutrition confusion
Not seeing progress
Time
Confidence in the gym
Which weekly investment range feels realistic for you at the moment? (This helps me recommend the right level of coaching — nothing is locked in)
$40 - $60
$60 - $80
$80 - $100 +
Not sure - happy to discuss
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