Personal Training Intake Form

Thank you for your interest in personal training with the SJCC! We are excited to work with you on your fitness and wellness goals.

Please fill out the form below to begin the intake process. Once we have received your form, we will reach out to you with more details and/or to request more information.

If you have any questions, please contact SJCC Fitness Manager Austin Williams at AustinW@sjcc.org.

Promo Description

Name*

First NameLast Name

Email*

example@example.com

Phone Number*

Please enter a valid phone number.

Are you a current SJCC member?*

YesNo

Birth Date*

MonthDayYear

Birthdate*

Date

I prefer to be paired with a Personal Trainer who identifies as:*

FemaleMaleNo preferenceOther

Please indicate when you are available for Training. Check all that apply.*

	6:30-8am	8-11am	11am-2pm	2-5pm	After 5pm	Unavailable
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday

How many times per week would you like to meet with a trainer?*

1 time a week2 times a week3+ times a week

What is your desired session length?*

30 minutes55 minutes

Please list any orthopedic or medical issues your trainer should be aware of:*

What are your fitness and health goals?*

Please share any additional information that would be helpful to your trainer:

Is there an SJCC trainer you specifically want to work with?

Would you be interested in group personal training?

YesNo

If yes, do you have a group already or would you like us to find you a partner to work with?

I have a group already.I would like you to find me a partner to work with.

What is your preferred form of communication?*

EmailTextPhone callNo preference

Personal Training Intake Form

Physical Activity Readiness Questionnaire