Rooted Personal Training intake form
This is where we lay the foundation. Your answers help me understand where you’re starting from, what you want to build, and how we can create a training approach that truly fits you. Take your time and answer honestly. After filling this out, I will contact you for a follow up - all without any obligation
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: +00 000 00 00 00.
Date of Birth
*
-
Day
-
Month
Year
Date
Gender
Male
Female
X
Occupation
Do you have any current or past medical conditions or injuries?
Are you currently taking any medications?
How would you describe your current physical activity level?
*
Sedentary (little or no exercise)
Lightly active (light exercise/sports 1-3 days/week)
Moderately active (moderate exercise/sports 3-5 days/week)
Very active (hard exercise/sports 6-7 days/week)
Other
What is your previous training or sports experience?
What are your main goals or expectations from your personal trainer?
*
Have you worked with a coach before?
*
Yes
No
If yes: what did you like and what did you like less?
Which of these goals apply to you (more than one possible)
build muscle
lose fat
improve endurance
get stronger
injury recovery
injury prevention
general health
mobility & flexibility
Training goals
Why those goals are important
How many times per week do you want to train?
How many hours do you sleep on average per night?
How high is your stress level?
1
2
3
4
Best
5
1 is , 5 is Best
Is there anything else you would like to add or I should know?
Submit
Should be Empty: