Personal Training Consultation Questionnaire
Full Name
First Name
Last Name
Date of Birth
Please select a month
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Month
Please select a day
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Day
Please select a year
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Year
Gender
Male
Female
Phone Number
Email
Emergency Contact
Name
Emergency Contact
Phone Number
Whats the activity level at your job?
None(seated only)
Moderate (light activity such as walking)
High (heavy labor, very active)
What are your top 3 fitness goals
Why are these goals important to you?
Have you ever worked with a personal trainer? If so what was your experience like?
What would success in this program look like for you?
How would you rate your current fitness level?
Beginner
Intermediate
Advanced
Do you currently have a gym member ship? If yes, which gym?
How many times per week do you exercise?
What type of exercise and activities do you enjoy most?
Are there any exercises or activities you dislike or want to avoid?
Do you have any current or past injuries that may affect your training? If yes, please explain.
Are you currently taking any medications that could impact physical activity?
Have you been diagnosed with any of the following conditions? (mark all that apply)
Heart disease
High Blood pressure
Type 1 diabetes
Type 2 diabetes
Asthma or other respiratory issues
Joint problems (e.g, arthritis)
Other
Do you have any physical limitations or concerns I should be aware of?
If you have any injuries, please list them.
Has a Physician ever advised you against participating in an exercise program?
Yes
No
How comfortable are you with using technology to track your fitness progress?
Very Comfortable
Somewhat comfortable
Not Comfortable
Do you currently use any of these wearable fitness devices (Select all that apply)
Apple Watch
FitBit
Garmin
Whoop
Oura Ring
How do you use your wearable device? (e.g., tracking steps, heart rate monitoring, sleep tracking, etc.)
Do you sync your wearable device with any fitness apps? (e.g., MyFitness Pal, Strava, Nike Training Club, True Coach)
Do you track your nutrition using any apps or tools? (e.g., MyFitness Pal, Cronometer, Noom, etc.)
Would you like to integrate data from your wearable device or apps into your training program for tracking progress?
Yes
No
At what times during the day would you prefer to train?
Morning
Mid-Day
Afternoon
Evening
How many days per week can you consistently train?
How easily do you build new habits? (1=difficult, 10=easily)
1
2
3
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5
6
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8
9
10
Timeline for achieving your goal
Rows
8 WKS
16 WKS
24 WKS
32 WKS
40 WKS
1 YEAR
N/A
Please rate your motivational level to do what it takes for reach your goal.
1
2
3
4
5
6
7
8
9
10
What are your expectations on me as your Personal Trainer?
Submit
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