Personal Fitness Training

Client Name*

First NameLast Name

Age*

Residence*

Street Address Line 2

City

Country

Phone Number*

Area CodePhone Number

Email*

example@example.com

Emergency Contact Name*

First NameLast Name

Emergency Contact Phone Number*

Area CodePhone Number

How would you rate your current level of physical activity?*

Sedentary/very inactive (no exercise at all)Somewhat inactive (once a week)Average (twice a week)Fairly active (three times a week)Extremely active (four-six times a week)

If you selected ‘somewhat inactive’ or above, please list the type of exercises you do.

When was the last time you worked out?*

On a scale of 1 to 5, how would you rate your level of stress? *

1 is , 5 is

On average, what is your energy level like most days?*

Low energyModerate energyHigh energy

What does your daily routine look like? This includes your waking and sleeping hours, and your mealtimes. Please include time stamps. *

Please provide a detailed breakdown of what one day of meals looks like for you. This should include what you eat for your main meals as well as snacks. Please include time stamps. *

Please share your fitness goals below. *

Please select the conditions that have affected your health either recently or in the past.*

	Yes	No
Broken/dislocated/fractured bones
Muscle strain/sprain
Arthritis or bone-related diseases
Diabetes type 1
Diabetes type 2
High blood pressure
Low blood pressure
Insomnia
Anxiety/depression
Surgery
Eye problems
Pain in any part of the body
Pregnancy
PCOS/any other hormonal problem
Poor mobility/movement limitations in any part of the body
Asthma/any other respiratory weakness
Heart problems
Spinal disorders
Cancer
None

If you selected any of the above conditions, please provide more detail (e.g. time of diagnosis, symptoms and any other details your personal fitness trainer should know).

If there is anything else you want to share, please do so below:

Your weight*

in KG

Your height*

in feet and inches

Using a measuring tape, kindly measure yourself In the following areas and write down the values below. *

	In inches
2 inches above belly button
On the belly button
2 inches below belly button
Hips
Thigh
Bicep (this must be done with your arm straight)

1. If at any point the client feels unwell and/or experiences pain or discomfort, she must notify the instructor immediately. This includes any rising medical conditions that the client feels may affect or be affected by doing exercises.

2. The client must notify the instructor when she is on her period or is pregnant. This is to ensure the safety and wellbeing of the client. Some exercises/poses can not and should not be done during both conditions and must not be taken lightly.

3. Any sessions postponed or missed by the instructor will be rescheduled.

4. Every session will have a 10-min waiting time. If the client does not show up for her session within those 10 mins without prior notification, that session will be canceled and will not be rescheduled.

5. Keeping in mind the unpredictable nature of clients’ work and home lives, the session timings can be changed or delayed, if notified at least 30 mins before the session starting time.

6. Whether the client opts for a 45 min session or less, the monthly cost will remain the same. This payment is non-refundable and has to be paid in advance. Once the payment has been made, the client will be able to begin her sessions.

7. Monthly charges are subject to change.

8. A client may postpone/reschedule 1 week's sessions. Any sessions postponed beyond that number will not be rescheduled.

9. Sessions that have been postponed can not be re-postponed.

10. The client must utilise her sessions within 5 weeks of the purchase date. A new cycle of sessions will begin after 5 weeks.

11. The client must not combine Fitl workout plans with any other workout plans. If she intends to do so, she must first discuss it with her trainer as it could lead to overtraining and as a result, injuries.

12. The client must keep her trainer up to date on any rising or resurfacing medical conditions.

13. The client must ensure there are no men in the view of the camera and session screen during sessions. This is to protect the modesty and privacy of the instructor. If this is not possible (due to any reason), the trainer must be notified so that appropriate measures can be taken at her end (this does not apply to clients attending their sessions in public spaces like mixed gyms etc).

14. The online fitness sessions are held in a room that is closed and covered on all ends to maintain the privacy and modesty of online clients.

15. Medical and contact information (and any other private information shared during online personal fitness training sessions) of the clients is confidential and is not shared with any other person.

16. The client may share the instructor’s personal contact information with potential clients.

17. Any feedback and constructive criticism from the client is highly appreciated and will help in improvement of services.

18. Addition of new policies or changes to existing policies will be applicable on clients from their new billing month.

I agree to the terms and conditions listed above

Personal Fitness Training

Terms and conditions