Client Consultation Form
Please fill in this form so I can assess your needs and contact you with an appointment.
Name
First Name
Last Name
Email
example@example.com
Phone
Preferred Contact Method
Email
Phone call
WhatsApp
Text
Other
What Are Your Main Goals
Strength / Performance
Weightloss
Bodybuilding / Body Shaping
Long Term Programming
Stress Relief / Mental Wellbeing
Injury Prevention / Technique
Other
What Service Are You Interested In
Personal Training 1-2-1
Sports Massage (Available in 2026)
Group Training (2-4 People)
Combination of PT & Sports Massage
Personal Training: Have you worked with a Personal Trainer before?
Yes
No
Personal Training: Current Activity Level
Sedentary
Lightly Active
Active
Very Active
Personal Training: Would you like progress photos?
Yes
No
Personal Training: Would you like to be featured on social media (instagram)
Yes
No
Personal Training: Desired Training Frequency
Once a month
Twice a month
Once a week
Other
What is your availability? (I will contact you with available appointments)
Rows
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Morning
Afternoon
Evening
All Day
For Group PT: Are you joining with others? (If yes please list names)
Do you have any current injuries or areas of pain? (Please describe)
Any history of DVT?
Yes
No
Do you have any chronic conditions (e.g, asthma, heart conditions, diabetes, OA)
Yes
No
Are you pregnant?
Yes
No
Do you take any drugs or medications?
Yes
No
Any mobility issues or exercises you struggle with? (Please explain)
Is there anything else you would me to know before scheduling you in?
Consent Statement: By signing and submitting this form, you consent to me contacting you with appointment options and relevant information for the services you have selected.
Submit
Submit
Should be Empty: