This short form will help me learn more about your goals, experience, and availability. After reviewing your responses, I will contact you with the next steps and the coaching options that may be the best fit for you.
Thank you for your interest in training with Coach T.
L³ Repeat helps people lose body fat, build strength, keep their shape, and feel more confident in the gym.
Full Name
First Name
Last Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Date of Birth
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Gender
Male
Female
Other
Current Weight
Height
BMI
Goal Weight
What is your main fitness goal right now?
*
Lose body fat
Build muscle and strength
Lose weight while keeping my shape
Improve my body composition
Become more confident in the gym
Improve consistency and accountability
Improve my overall health and fitness
Other
What has been your biggest challenge?
Staying consistent
Not knowing what workouts to do
Not knowing how to use gym equipment
Feeling uncomfortable in the gym
Lack of motivation
Lack of accountability
Time management
Nutrition habits
Previous injuries or physical limitations
Other
How would you describe your current fitness level?
Beginner — I am new to working out or returning after a long break
Intermediate — I exercise sometimes but need more structure
Experienced — I train consistently but want better programming or accountability
Do you have any injuries, medical concerns, or physical limitations that could affect exercise?
No
Yes
I am not sure
Training Preferences: Which option are you most interested in?
One-on-one personal training
Partner training
Small-group training
Online coaching
Hybrid coaching
I am not sure yet
How often would you like to train?
Once per week
Twice per week
Three times per week
I am not sure yet
When would you like to begin?
As soon as possible
Within the next two weeks
Within the next month
I am exploring options for the future
Which statement best describes where you are right now?
I am ready to start and invest in personal training
I am interested and would like to review the packages first
I am not ready yet, but I would like to stay connected
Please confirm the following:
I understand that submitting this form does not guarantee a training spot.
I understand that I must complete a health screening, waiver, and training agreement before beginning.
I understand that my training spot is not confirmed until payment and all required forms are completed.
Thank you for your interest in L³ Repeat Personal Training. Coach T will review your responses and contact you within two business days to discuss your goals, availability, and the best next step. Lift. Learn. Live. Repeat.
Please confirm by leaving initials above.
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