Personal Training Client Intake Form
Please fill out your personal details, fitness background, motivation, goals, scheduling preferences, health information, and consent.
Personal Information
Full Name
*
First Name
Last Name
Age
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
Fitness Background
Do you have experience with resistance training or have you worked with a trainer before?
*
Yes
No
How would you describe your current activity level?
*
Please Select
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)
Extra active (very hard exercise & a physical job)
Motivation
What is motivating you to work with a trainer?
*
Goals
Please describe your primary fitness goals.
*
Scheduling
How many days per week are you looking to work with me?
*
What days/times would work best for your schedule?
*
Health
Do you have any current or previous injuries that may affect your exercise?
*
Yes
No
Do you have any medical conditions we should be aware of?
*
Yes
No
Do you have any physical limitations that may impact your exercise?
*
Yes
No
Consent
Signature
*
Date
*
-
Month
-
Day
Year
Date
Submit
Submit
Should be Empty: