Client Profile Form
TIMELESS STRENGTH | LASTING LEGACY
Client Information
Name
First Name
Last Name
Age
Date of Birth
-
Month
-
Day
Year
Date
Gender
Male
Female
Email
example@example.com
Phone Number
Format: (000) 000-0000.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Occupation
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Health History & Metrics
Height (in)
Weight (lbs)
Please list injuries, medical conditions, physical limitations, surgeries in the last 5 yrs we should be aware of along with active medications.
Are you currently taking any exercise program or a part of a gym?
Yes
No
If yes what program or gym?
How many times do you exercise a week?
Have you worked with a personal trainer before?
Yes
No
If yes, what worked well, and what didn’t?
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Goals & Focus
What are your fitness goals?
Weight Loss
Tone Muscles
Be Physically Fit
Improve Overall Health
Increase Mobility/Flexibility
Functional Strength
Increase Energy
Reduce Pain
Improve Endurance
Improve Cardiovascular Health
Other
What does “success” look like for you in your fitness journey?
What inspires you to prioritize your health and fitness right now?
How would achieving your goals improve your daily life or bring you joy?
If you could say one thing about your health in the future, what would it be?
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Schedule & Preference
Preferred session setting?
Please Select
Haven- Your home
Immersive- Designated outdoor location
Studio- Botique partner studio
Preferred training frequency and days?
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Preferred session time?
5-8 AM
8-12 PM
1-4 PM
5-8 PM
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Nutrition & Supplements
Specific dietary preferences or restrictions?
Avg meals per day?
Current Supplements?
Extra credit
Who’s your favorite musician or band?
What are your hobbies or favorite activities outside of fitness?
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