N10ERGY FITNESS ONLINE PERSONAL TRAINING CONSULTATION
Complete as many details as possible to help us support you in getting the most out of your training!
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Date Of Birth
*
-
Day
-
Month
Year
Date
Height (cm)
*
Weight (Kg)
*
What job do you currently do?
What is the activity level of your current Job?
Current Health & Activity
This helps us understand your current activity and medical status
Do you have any diagnosed health problems? Please list:
Are you currently taking medication? Please list:
Do you have any injuries? Please list:
Has anyone in your immediate family developed Heart Disease before 60?
*
Yes
No
Do you suffer from diabetes, asthma, high or low blood pressure?
*
Yes
No
Are you a cigarette smoker?
Yes
No
Are you training (Weights or Cardio) 3 or more times per week currently?
Yes
No
What describes your current nutritional approach
*
Vegan/ Veggie
Low Carb
Low Calorie
No Specific Diet
How Can We Help You?
This last section ensures we know how to best get you the results you want!
What are your health and fitness goals you want to reach with our support
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General Health
Improved Strength
Improved Fitness
Fat Loss
Aesthetic Changes
Have you worked with a Personal Trainer before?
Yes
No
At what time of day would you ideally be training at the gym?
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5am-9am
9am-12pm
12pm-4pm
4pm-7pm
7pm-9pm
What day(s) would you ideally train on?
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Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
How Many Personal Training sessions would you like to do weekly?
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1 Day
2 Days
3 Days
4 Days
Would like to discuss with a trainer
What are your expectations from your personal trainer? What do you need from our PTs?
Lastly, how did you find out about the N10ergy Studio?
*
Referral from a friend or family
Walked past the studio
Google/AI search
Social media
Sponsorship (APFC Kit Sponsor)
Spoken directly to an N10ergy Trainer
Other
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