Personal Training Intake Form

Personal Training Intake Form
Customer Details:
Full Name*

First NameLast Name
Phone Number*
E-mail*
example@example.com
Gender Identity*
Birthday*

MonthDayYear
Date
Emergency Contact Info

First NameLast Name
Their Phone Number
Please enter a valid phone number.
Fitness Goals & Preferences
Tell me about your Short and Long term fitness goals*
Why are these goals important to you, and what would be different in your life when you achieve these goals?*
What's stopped you in the past from reaching your goals?*
Scale of 1-10 How serious are you?*
What can I do to help you reach your goals? Be specific.*
Any hobbies outside the gym?
Any illness or injury?*
Explain if yes.
How active are you in your day to day?
Preferred Training Style?
What kind of workouts do you enjoy or think you might enjoy?
Any questions for me?
Nutrition and Habits
Do you follow any specific dietary guidelines or preferences?
Do you want nutritional guidance as part of your training program? (+$40/Mo.)
How many hours of sleep do you usually get at night?
How would you rate your stress level? (1-10)
Next Steps:

After completion of this intake form, I will be in contact with you via Email where we can discuss payment and location of training.

Payment:

Sessions are priced based on time:

30 Minute Sessions are $45 for a single, $240 for 6 and $420 for 12. Payment is expected up front!

45 Minute Sessions are $65 for a single, $360 for 6 and $660 for 12

60 Minute Sessions are $85 for a single, $480 for 6 and $840 for 12

Cancellations:

In the event of cancellations, I ask that there be at least 12 hours notice. Any cancellation that occurs without it will result in me taking a session. All sales are final.

What you can expect from me:

I will be a coach that cares for you as a client. You will have a gameplan for every time you set foot in the gym in 1-6 week blocks. I will give you my best and I will expect the same out of you. If you have questions, you have access to me via phone and email on weekdays 12pm-7:30pm pending I'm not with another client.
I agree to the above terms and conditions*

YesNo
Please verify that you are human*
Should be Empty:

Personal Training Intake Form

Fitness Goals & Preferences

Nutrition and Habits