Coaching Consultation & Application Form

Coaching Consultation & Application Form

Please fill out the form below and I look forward to starting with you!
Full Name

First NameLast Name
Date of Birth
I.e., 20/09/1998
What are the fitness goals that you hope to achieve by working with me?
I.e., I would like to lose fat and tone up, while increasing my gym confidence.
On a scale of 1-10, how ready are you to achieve these goals?
What is your activity level during work?
Are you currently performing any kind of exercise outside of work?
I.e., I currently go jogging for 30 minutes after I get home from work. // I currently am not exercising.
Are you currently performing any exercise or have previous experience?
I.e., I have little bits of experience weightlifting. // I dont really have any experience with exercise.
Have you ever worked with a personal trainer before or done anything else to achieve your goals? If so, what do you believe prevented you from reaching your goals?
I.e., I have tried researching good exercises to do but it felt wrong when I tried them myself.
What service(s) are you interested in? (You can select multiple.)
How many Sessions would you like per week?
Email Address
example@example.com
What is your preferred contact method?
Social Media handle (If this is your preferred method):
I.e., John.doe123 on instagram / Jane Doe on Facebook / 07812 123456
Phone Number (If this is your preferred method):

Area CodePhone Number
Are you willing to take progress photos (that may be shared on social media?)
Are you willing to allow training footage to be posted on social media?
If you have any diagnosed medical condition(s) AND/OR Injuries please list them down below.
Are there any considerations regarding Mental Health & confidence in the Gym you would like me to be aware of? (Feel free to skip this question).
I.e. Stress, Anxiety, Depression, Lack of motivation, Insecurity in the gym, etc.
Is there anything else you would like me to know?
In regards to anything previously mentioned or something not covered in the above questions.
Should be Empty: