Training enquiry
Name
First Name
Last Name
Gender
Female
Male
Other
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Date of Birth
*
-
Month
-
Day
Year
Date
Height
Weight
Diet and Nutrition
Give as honest and detailed answers as you can, this will help me understand you a lot more.
Your current diet - (Outline your current diet and any other information regarding this topic e.g. past/present eating disorders, diets you have tried etc)
Physical Activity & Goals
What would you like to achieve?
Which of the following statements fit in with your goals?
Improved health
Gym confidence
Strength
Muscle growth
Fat loss
Performance
Body confidence
Accountability
What has stopped you from achieving this goal?
What is your current training plan like? (How many days, if you do any other type of exercise)
What is your daily activity level?
None
1
2
3
4
High
5
1 is None, 5 is High
What is your daily stress level?
Low
1
2
3
4
High
5
1 is Low, 5 is High
How often do you want to do personal training a week?
Mondays
Tuesdays
Wednesdays
Thursdays
Fridays
Saturdays
Sundays
Please rate your readiness to change.
Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
Do you have any existing medical conditions?
Submit
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