ELITEFIT & COACHING
Consultation Form
Please fill out consultation form
with as much detail as possible.
Full Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Instagram name
Facebook name
Age
Height (centimetres)
Currently Weight (Kgs)
Do you follow a regular working schedule, do you work days, afternoon or nights?
How many days would you like to train?
One
Two
Three
Four
Five
What times are you generally available for training?
Early Morning (5am-8am)
Morning (8am-12pm)
Afternoon (12pm-5pm)
Evening (5pm-8pm)
If you have any diagnosed health problems list the condition(s).
If you are on any medications, please list them.
If you have any injuries, please list them.
What additional therapies are being undertaken for the given injury?
Have you had surgery in the past 12 months.
Yes
No
If yes, please list the surgery you had.
Do you suffer from diabetes, asthma, high or low blood pressure?
Yes
No
If yes, Please list:
Are you a current a cigarette smoker or vaper?
Yes
No
What Is your current fitness level?
Beginner
Intermediate
Advanced
What following goals would you like to achieve?
General Health & Wellness
Build muscle
Increase Endurance
Lose Weight
Improve Flexibility
What is your main Goal with training?
Why is this Goal important to you?
Are you currently exercising regularly (at least 3x per week)?
Yes
No
Please describe your exercise history.
As Your Personal Trainer is there anything else you would like me to know? (Questions, concerns, expectations ect.)
Signature
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