Soulfull Yoga and Fitness Personal Training Consultation Form

Soulfull Yoga and Fitness Personal Training Consultation Form

Share your goals, availability, and contact details to get started.
Full Name

First NameLast Name
Date of birth

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: 00000-000000.
Preferred contact method
What are your primary health and fitness goals? What’s the #1 thing you want to achieve in the next 90 days?

Other
What is your main long-term goal?
Do you currently have pain or discomfort that affects daily activity or exercise?
Have you had an injury, surgery, or recurring issue that still affects how you move or exercise?
Are there movements, exercises, positions, or activities you currently avoid?
Have you worked with a physiotherapist, doctor, or other clinician for a current concern?
If you answered yes to any question, share relevant details:
Has a doctor or healthcare professional advised you not to exercise, or advised supervised exercise only?
Do you have a diagnosed heart, lung, metabolic, neurological, or musculoskeletal condition that may affect exercise?
Do you experience chest pain, dizziness, fainting, unusual shortness of breath, or heart palpitations during activity?
Are you taking medication that may affect exercise, heart rate, blood pressure, balance, or recovery?
Have you had surgery, hospitalisation, or a significant illness in the past 12 months?
Are you currently pregnant, postpartum, or returning to exercise after pregnancy?
If you answered yes to any question, share relevant details and any guidance from your health care professional:
How many hours of sleep do you usually get?
On a scale of 1–10, How would you rate your current stress level?

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1 is Low, 10 is High
How active is your typical day outside planned exercise?
Do work, travel, caregiving, or other commitments regularly affect your routine? Or anything else that may affect your routine, energy, or recovery?
If Yes, Please provide details:
What challenges or barriers have stopped you from achieving your goals? What usually throws you off track when trying to stay consistent?
Would you like nutrition habits or meal planning included in your coaching plan?
More specifically, What would you like to achieve through personal training?
Why does this matter to you right now?
What would meaningful progress look like in the next 90 days?
On a scale of 1–10, how committed are you to achieving your goals?

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1 is Low, 10 is High
How would you describe your exercise experience?
On a scale of 1- 10, how would you rate your current fitness level?

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1 is Low, 10 is High
Please briefly describe your current fitness routine (if any) Activities and/or Sports
What sort of physical activities do you enjoy or dislike?
Where do you prefer to exercise?

Other
What equipment do you have access to?
Personal Training Preferences
Preferred Training times
Realistic Exercise frequency
Preferred session length
I confirm that the information I have provided is accurate to the best of my knowledge. I understand that I should inform my coach if my health, pain, medication, pregnancy/postpartum status, or relevant circumstances change. I understand that my coach is not providing medical diagnosis or treatment and may recommend that I seek guidance from a qualified healthcare professional.
Emergency Contact

First NameLast Name
Phone Number

Area CodePhone Number
Signature
Date

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Should be Empty: