Personal Training Consultation Form

Personal Training Consultation Form

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

First NameLast Name
MaleFemale
Date of Birth*

MonthDayYear
Age
years
Height
ft
Weight
Kg
Phone Number

Area CodePhone Number
Email
What do you do for a living?
none(seated only)Moderate (light activity such as walking)High (heavy labor, very active)
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.
YesNo
YesNo
if yes please list:
YesNo
YesNo
If yes what type ?
12345678910
Improved HealthTone UpIncreased StrengthIncreased Muscle MassFat LossWeight GainBuild Gym Confidence
What is your goal with your training?
Why?
YesNo
YesNo
MorningMid-DayAfternoonEvening
HomeGym
YesOnly for PT to seeOnly for personal trackingNo
What are your expectations on me as your Personal Trainer?
YesNoMy fitness pal
Any more relevant information that I should know ?
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.
YesNo
Should be Empty: