Personal Training Consultation Form La Puente

Training Consultation Form

This form is to schedule (1) free group workout ONLY.
Which training do you prefer?
Which Location?
Full Name*

First NameLast Name
Date of Birth*

MonthDayYear
Age
years
Height
ft
Weight
If unknown that's okay
Phone Number

Area CodePhone Number
Email
Social Media Handle
(If preferred form of contact)
How do you prefer to be contacted?
What do you do for a living?
Whats the activity level at your job?

none(seated only)Moderate (light activity such as walking)High (heavy labor, very active)
What is your work schedule?
Are you currently excersising?

YesNo
Do you have any diagnosed health problems? Please list.
If you are on any medications, please list them.
If you have any injuries, please list them.
Please rate your readiness for change.

12345678910
What following goals does best fit in with your goals?

Improved HealthTone UpIncreased StrengthBuild a bootyFat LossWeight GainBuild Gym Confidence

TImeline for achieving your goal.

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

Have you trained at a different gym before? (Bootcamp, Crossfit, etc. ...)

YesNo
Any takeaways from that experience? (If applicable)
Which of the following days do you prefer to come in for a trial workout?

Monday (Leg Day)Tuesday (Upper Body Day)Wednesday (Glute Day)Thursday (Full Body Day)Friday (Leg Day)
Which time?
Booty Boutique LLC is committed to safeguarding your personal information. In compliance with the Telephone Consumer Protection Act (TCPA), by providing your contact information, you expressly consent to receive marketing, informational, and transactional messages via SMS, email, and telephone.
I AGREE TO THE ABOVE TERMS & CONDITIONS!*

YesNo
Should be Empty: