C FIT NEW CLIENT APPLICATION
Part 1. Basic information
Full Name
First Name
Last Name
Gender
Male
Female
Age
years
Height
cm
Weight
LBS
After you fill out the application, an email with my pricing and program info will be sent straight to your inbox!
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
What is your preferred method of contact?
Call
Text
Email
I usually like to set up a quick in-person or phone consult once I reach out, just to get to know you better, chat goals, and make sure it’s a good fit. Which option would you prefer?
Phone Consult
In Person
Part 2. Lifestyle Information
What do you do for a living?
Whats the activity level at your job?
None (seated only)
Moderate (light activity such as walking)
High (heavy labor, very active)
Which services are you interested in hearing more about?
In-Person Training (Lafayette, LA)
Online Coaching
Bootcamp Classes
Nutrition Only
Hybrid online/In person
If you're interested with in-person training, I'd like to know what time slots work best for you. Please let me know your preferred times or any specific scheduling requirements you have, and I'll do my best to accommodate them.
How many times a week are you interested in training?
1
2
3
4
Part 3. Medical and Health Information
If you have any diagnosed health problems list the condition(s). If you have any injuries, please list them.
Part 4. Goals
What specific goals are you looking to achieve from a fitness and nutrition program?
Are you currently exercising regularly (at least 2x per week)?
Yes
No
Have you trained with a personal trainer before?
Yes
No
What are your expectations on me as your Personal Trainer?
How did you hear about us?
Submit
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