• Personal Training Consultation Questionnaire

    Please fill out this form to help me understand your needs & goals with training. All responses will remain confidential.

  • Part 1. Basic information

  • Gender*

  • Part 2. Lifestyle Information

  • What’s the activity level at your job?*
  • How often do you travel?*

  • Part 3. Medical and Health Information

  • Are you experiencing any stress or motivational problems?
  • Has anyone of your immediate family developed heart disease before the age of 60?*
  • Do any diseases run in your family?*
  • Do you suffer from diabetes, asthma, high or low blood pressure?*
  • Your current diet could be best characterized as:*

  • Part 4. Goals

  • Please rate your readiness for change.*
  • What following goals best fit in with what you’re looking for from personal training?*
  • Rows
  • Please rate your motivational level to do what it takes to reach your goal.*

  • Part 5. Training

  • Are you currently exercising regularly (at least 3x per week)?*
  • Have you trained with a personal trainer before?*
  • At what times during the day would you prefer to train?*

  • Please Read The Following Terms and Conditions

  • 1.) CANCELLATIONS

    Cancellations should be made at least 24 hours in advance of a scheduled session. Sessions cancelled less than 24 hours in advance will be charged in full to the client.

     

    2.) LATE ARRIVALS

    Each session shall be 1 hour in length. Sessions will not be extended (unless time is available) due to the lateness of the client or due to interruptions caused by the client.

     

    3.) ALL THE INFORMATION I HAVE GIVEN IS CORRECT

    All the information on this form is correct and to the best of my knowledge. I have sought and followed any necessary medical advice. I understand that all the information given will be kept confidential.

     

  • I AGREE TO THE ABOVE TERMS & CONDITIONS*
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