Personal Training Consultation Form
Please fill in all the details and I look forward to getting started!
Full Name
*
First Name
Last Name
Gender
Male
Female
Phone Number
-
Area Code
Phone Number
Email
What following goals does best fit in with your goals?
Improved Health
Tone Up
Increased Strength
Increased Muscle Mass
Fat Loss
Weight Gain
Build Gym Confidence
How do you prefer to be contacted?
Please Select
Email
Phone (Text/Whatsapp)
Social Media
What is your current level of activity?
none
Moderate (light activity such as walking)
High (very active)
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.
Are you experiencing any stresses or motivational problems?
Yes
No
Do you suffer from diabetes, asthma, high or low blood pressure?
Yes
No
if yes please list:
At what times during the day would you prefer to train?
Morning
Mid-Day
Afternoon
Evening
Is it okay to post photos and videos to social media of training and/or progress photos?
Yes
No
Only Training
Only Progress
Are you okay with Progress Photos (taken personally)?
Yes
Only for PT to see
Only for personal tracking
No
I AGREE TO THE ABOVE TERMS & CONDITIONS!
*
Yes
No
Submit
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