Personal training enquiry
Name
*
First Name
Last Name
D.O.B
*
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
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Medical check
Do you have high or low blood pressure? Please specify
*
What is your current weight in kg?
Do you have any diagnosed health conditions? Please specify.
*
Do you take any medication? Please specify.
*
Do you have any current injuries? Please specify.
*
Have you had any past injuries? Please specify.
*
Are you pregnant or recently postpartum? Please specify. Eg. 4 months pregnant or 4 weeks postpartum.
Is there anything else you may want me to know before we start 1-1 personal training?
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Lifestyle and Training
What is your occupation?
Have you trained with a personal trainer before?
List some of your goals that you want to achieve. Eg. Lose fat, increase muscle mass or improve overall health.
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Do how often do you train per week? Eg. 2-3 days a week.
Are there any exercises or movements we need to AVOID when training? Please specify why.
Is there any exercises or movements you really enjoy when training?
When would you want to achieve your results by?
How active would you say you were on a day to day basis?
Not active
Moderate (light activity)
Active
Very active
What days/times suit you best to train during the week?
Any further information you want me make me aware of please type in this box.
I consent to providing any information given in this form to Emilia Falcone.
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