Personal Training Consultation Questionnaire

Full Name

First NameLast Name

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Email

example@example.com

Gender

Date of Birth

MonthDayYear

Age

years

Height

cm

Weight

KG

What do you do for a living?

Whats the activity level at your job?

Please list the physical activities that you participate in outside of the gym and outside of work:

Do you follow a regular working schedule, do you work days, afternoon or nights?

If you have any injuries, please list them.

Are you experiencing any stresses or motivational problems?

Please rate your readiness for change.

What following goals does best fit in with your goals?

What is your goal with your training?

Why?

TImeline for achieving your goal.

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

How often are you willing to train a week to reach your goal?

Please rate your motivational level to do what it takes for reach your goal.

Have you trained with a personal trainer before?

What had been your biggest challenge in your fitness journey?

Are you willing to commit to 3 months of working together to see results?