Personal Training Consultation Form

Personal Training Consultation Form

Please fill in all the details and I look forward to getting started!
Instagram handle
Full Name

First NameLast Name
Gender

Other
Age
years
Height
ft
Weight
If unknown that's okay
Phone Number

Area CodePhone Number
Email
How do you prefer to be contacted?
What do you do for a living?
Whats the activity level at your job?
Do you follow a regular working schedule, do you work days, afternoon or nights?
Please list the physical activities that you participate in outside of the gym and outside of work.:
If you have any diagnosed health problems list the condition(s).
If you are on any medications, please list them.
If you have any injuries, please list them.
Do you suffer from diabetes, asthma, high or low blood pressure?
if yes please list:
Are you a current cigarette smoker?
Please rate your readiness for change.
What following goals does best fit in with your goals?
What is your goal with your transformation?
Why? (IMPORTANT)

TImeline for achieving your goal.

Rows	8 WKS	16 WKS	24 WKS	32 WKS	40 WKS	1 YEAR
NOW

Are you currently excersising?
Have you trained with a personal trainer before?
How often are you willing to exercise each week?
Please Choose
Is it okay to post photos and videos to social media of training and/or progress photos?
What are your expectations on me as your Transformation Specialist?
Once your application is reviewed, I will reach out to schedule a consultation. We will decide if what I have to offer is what you're looking for and if you are a type of client I am willing to add to the team. Thank you and good luck!

-Coach Kimo
Should be Empty: