Personal Training-New Client Questionnaire

Full Name*

First NameLast Name
Email*
example@example.com
Phone Number*

Area CodePhone Number
Gender*

MaleFemale
Date of Birth*

MonthDayYear
Age
Height
Weight
Are you most interested in..*

1 on 1 trainingOnline coachingNutrition coachingPowerlifting coachingOther
Why are you looking for a personal trainer?*
Have you worked with a personal trainer before?

YesNo
If yes, what kind of training did you do:
What are your expectations on me as your Personal Trainer?
What would your availability look like?
Current goals (short and long term):*
Amount of time desired to reach your goals (if applicable):
How often are you willing to train a week to reach your goal?
Current workout regimen (include any cardio, lifting, classes, extracurricular/bar league activities, etc.):
Current nutrition regimen (walk me through a typical day of eating for you and your current macros, if applicable):
Do any of the following apply to you?

VegetarianVeganGluten freeLactose intolerantPollotarianOther
Any other foods you hate/are allergic to?
Have you ever tracked your food/macros before?

YesNo
List any previous dieting methods:
Current supplements/medications:
Any current/previous injuries/surgeries? Other exercise limitations I should be aware of?*
Signature*

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