DP FIT Coaching Application
All information submitted will be kept confidential.
Customer Details:
Full Name
*
First Name
Last Name
Phone Number
*
Format: (000) 000-0000.
E-mail
example@example.com
Have you ever worked with a trainer before (online or in person)
Yes
No
What is age / height / weight
Do you have any medical conditions?
Yes
No
Are you taking any medications?
Yes
No
What are your overall fitness goals: what do you want to achieve in our time together?
What is your occupation and for how long?
Do you currently take any vitamins and/or nutritional supplements? Please also include any enhanced supplements/PEDs.
How many days a week are you actively in the gym or exercising?
I am not currently training or working out.
1-2 days per week
3-4 days per week
5-6 days per week
Everyday
Commitment to bettering yourself (1-10)
1- Low / 10- High
Submit
Should be Empty: