Consultation Form
Fill in the details below, looking forward to working with you.
First Name
Last Name
Gender
Female
Male
Date of Birth
-
Month
-
Day
Year
Date
Age
Years
Weight
Height
ft
Phone Number:
Email:
Do you have any communication preference?
Yes
No
What do you do for a living?
What’s the activity level at your job?
What shifts are you doing? (Day shifts, Night shifts etc)
Please list below the physical activities you participate in outside of work and gym:
Do you have a diagnosed health problem/have you in the past? List below if so
If you are on any medications please list them:
Do you have any current injuries? List below if you do
Are you experiencing any motivation problems?
Yes
No
Do you suffer from diabetes, asthma or low/high blood pressure?
Yes
No
What type of coaching are you looking for?
Online coaching
In person coaching
Both
Do you have access to a gym?
Yes
No
Have you had a personal trainer before?
Yes
No
What time in the day are you interested in training?
Morning
Midday
Afternoon
Evening
How often do you train a week?
Once a week
Twice a week
Three times a week
Four or more times a week
What’s your current level of gym experience?
How many 1-1 sessions would you want a week?
1 session
2 sessions
Are you happy to have sessions posted on social media? (Videos or pictures)
Yes
No
Are you okay to have progress photos taken?
Yes
No
Only for client and trainer to see
Submit
Should be Empty: