Personal Training Consultation Questionnaire

Training Options Available:

Full Name

First NameLast Name

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Email

example@example.com

Social Media Handle (pls specify which app)

ex: IG/evesquats

Age

years

Height

cm

Weight

LBS

What do you do for a living?

Whats the activity level at your job?

Do you follow a regular working schedule, do you work days, afternoon or nights?

Please list the physical activities that you participate in outside of the gym and outside of work.:

If you have any diagnosed health problems list the condition(s).

If you have any injuries, please list them.

Are you experiencing any stresses or motivational problems?

Do you suffer from diabetes, asthma, high or low blood pressure?

Please list:

Please rate your readiness for change.

What following goals does best fit in with your goals?

Ultimately, what is your “why” when it comes to achieving your goals?

Please rate your motivational level to do what it takes for reach your goal.

Are you currently excersising regulary (at least 3x per week)?

Have you trained with a personal trainer before?

What kind of training did you do?

What are your expectations on me as your Personal Trainer?

1.) CANCELLATIONS

Cancellations should be made at least 24 hours in advance of a scheduled session. Sessions cancelled less than 24 hours in advance will revoke free consultation & will need to pay a deposit to reschedule.

2.) LATE ARRIVALS

Each session shall be 1 hour in length. Sessions will not be extended (unless time is available) due to the lateness of the client or due to interruptions caused by the client.

3.) ALL THE INFORMATION I HAVE GIVEN IS CORRECT

All the information on this form is correct and to the best of my knowledge. I have sought and followed any necessary medical advice. I understand that all the information given will be kept confidential.

I AGREE TO THE ABOVE TERMS & CONDITIONS!