Consult Form

Consult Form

It can be hard taking the first step into change, you are about to step into the unknown, foreign land, which is why it is also great. Are you ready to unlock your full potential and see how far you can go? If so, complete the questions below and lets take on these challenges together. You will not be alone. Please be advised all information shared is confidential.
Full Name

First NameLast Name
Gender

MaleFemaleOther
Age
Height
Weight
Please provide me with your contact details (i.e contact number/email address etc)
Are looking for online coaching or 1-1?

1-1Online Coaching
What is your occupation?
If you have any diagnosed health conditions, please explain.
Do you have any allergies?
Please list any medications you may be taking.
If you have had any past or current injuries, please list and explain them.
Are you a current cigarette/vape smoker?

YesNo
Do you drink and/or take drugs? If so how often?
If possible, can you briefly explain your current diet?
If you know your current calories/macros, please list them below.
What are your goals?

Increase StrengthIncreased Muscle MassFat LossImproved EnduranceImproved HealthOther

Timeline for achieving your goals.

Rows	8 Weeks	16 Weeks	24 Weeks	32 Weeks
Now

Please explain if you have had any form of training history.
Have you been currently training?

YesNo
Have you had a personal trainer before?

YesNo
How often are you willing to train (per week)?

2-3 times p/w3-4 times p/w4-5 times p/w5-6 times p/w
How often do you want to do personal training a week (if applicable)?
Please Choose
What times of the would you prefer to train?

MorningMid-DayAfternoonEvening
What are your expectations of me as your personal trainer?
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 around 1 hour in length. Sessions will not be extended (unless time is available) due to the lateness of the client.

3.) ALL THE INFORMATION I HAVE PROVIDED 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 provided will be kept confidential.

4.) I WILL FILL OUT WEEKLY CHECK IN FORMS, PROGRESS PICTURES AND GIVE 100% EFFORT TO THE PROGRAM

Check in forms and progress pictures allows me to help you to the best of my ability, whilst allowing you to track your progress along the way, helping to better your confidence.
I AGREE TO THE ABOVE TERMS & CONDITIONS.

YesNo
Signature
Please let me know why you chose to join the team, was there anything specific? Was it via social media or something else?
Should be Empty: