Personal Training Consultation Form

CONSULTATION FORM
Full Name*

First NameLast Name
Gender*

MaleFemale
Age*
Height*
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Choice of Contact?

Text/CallEmail
Current Weight
Goal Weight
Current Activity Level

Little or no exerciseLight exercise or sports 1-3 daysModerate exercise or sports 4-5 daysHeavy exercise or sports 6-7 days
Current Fitness Level

Beginner - less than 6 months of consistent exerciseIntermediate - 6 to 12 months of consistent exerciseAdvance - over 12 months of consistent exercise
What is your Main Goal?

Weight lossBuild Muscle MassImproving Strength PerformanceVitality and HealthOther
How long have you wanted to achieve this goal?*
Why are these goals important to you? How will they impact your life?*
Do you have any additional goals?

Stress ReductionPostureCardiovascular HealthFlexibility/MobilitySelf EsteemOther
On a scale of 1 to 5, how ready are you to adjust your lifestyle (nutrition, sleep, stress management etc) to achieve your goal?*

1

2

3

4

5

1 is Not Ready, 5 is READY!
Have any of the following prevented you from achieving your goals in the past?*

BoredomLack of knowledgeLack of accountabilityLoss of motivationTrying to do too muchDid not have a programProcrastinationInjuryOther
Have you trained with a personal trainer before?*

YesNo
What are your expectations on me as your Personal Trainer?*
What could possibly hold you back from training?*

TimeBudgetMindsetAll of the above
What style of training do you prefer?*

The Cheerleader - Inspiring and supportiveThe Coach - Educational and MotivatingThe Drill Sergeant - Hardcore and straight to the point
Do you have any injuries or limitations?*

YesNo
If you have any injuries, please list them.
How many days can you commit to exercise?
How often do you want to do Personal Training a week?
Please Choose
Which are your preferred days to exercise?

MondayTuesdayWednesdayThursdayFridaySaturday
At what times during the day would you prefer to train?

MorningMid-DayAfternoonEvening
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 be charged in full to the client.

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!*

YesNo
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CONSULTATION FORM