Personal Training Intake Form

Personal Training Intake Form
Customer Details:
Full Name*

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

MonthDayYear
Date
Tell me about your short and long term goals.*
Why are these goals important?*
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?
Any questions for me?
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 $45. Payment is expected up front and sessions will last for 45 minutes.

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 a fee of $25. 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: