New Client Questionairre

New Client Questionairre

Personal Information
Name

First NameLast Name
Date

MonthDayYear
Date
Birthday

MonthDayYear
Date
Email
example@example.com
Phone Number
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Fitness Goals
What are your top fitness goals? (Ex. weight loss, muscle gain, flexibility, edurance)
What is your target time frame to achieve these goals?
Are there specific areas you would like to improve? (Ex. strength, agility, balance)

Current Fitness Status
What is your current fitness level?

BeginnerIntermediateAdvanced
What does your current fitness routine look like, if any?
Have you previously worked with a personal trainer?

YesNo
If yes, please describe your experience.

Health + Medical History
Any current or past injuries. If yes, please explain.
Are you currently taking any medications? If yes, please list them.
Are there any medical conditions that I should be aware of?

Nutrition + Supplements
Are you currently taking any supplements? If yes, please list them.
Do you follow a specific diet or have any dietary restrictions?

Mindset + Commitment
How committed are you on achieving your fitness goals?

1

2

3

4

5

1 is Worst, 5 is Best
What motivates you to stay consistent with your fitness routine?
What challenges do you face while maintaining a fitness routine?

Referral + Expectations
How did you hear about me? If someone referred you, please list their name.
What are your expectations from a personal training program?
Is there anything else you would like to share with me about your fitness journey, expectations, etc?
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