Personal Training Consultation Form
Name:
*
First and Last
Phone Number:
*
-
Area Code
Phone Number
E-mail:
Have you worked with a personal trainer in the past ?
Yes, I have
No, I have not
What are you looking For?
Looking to start you fitness journey (Beginner)
Looking to achieve goals to improve quality of life (Lifestyle)
Looking to prepare for a competition (Athlete)
What is your main fitness goal?
Loosing weight
Gaining Muscle
Maintaining Muscle Mass
Improving Mobility and Flexibility
Do you currently attend a gym/training facility? (Commercial gym, yoga studio, pilates, martial arts, studio ect)
Yes
No
If you do participate in other physical activity/sports what are they ? (Kick boxing, football, basketball, soccer, ect)
If you attend the gym regularly how frequently do you train within the week ?
I do not attend the gym regularly
1-2 a week
3x a week
4-5x a week
6-7x a week
Lets talk about your eating habits. What do you typically eat during a day. (Cereal for breakfast, Eggs and Toast ? Do you typically lunch and supper ? What do your snacks consist of ?)
For a diet to work, you must stay consistent and disciplined, are you willing to embark on your journey towards change ?
Yes! I'm all in
I'm looking for a more moderate/lenient diet
No, I am not too serious about changing my eating habits
How much water do you consume per day approximately?
500ml (4 glasses or less)
1L a day (8 glasses of water)
1.5 L a day
2 L a day
3L and +
How much protein do you consume a day on average from whole foods and supplementation ?
less than 50 grams
50 grams
100 grams
150 grams or more
Which supplements do you take ? (Select all that apply)
Protein Powder (Whey, Casein, Plant-Based)
Creatine Monohydrate
BCAAs (Branched-Chain Amino Acids)
Pre-Workout
Multivitamins
Fish Oil (Omega-3s)
Glutamine
Electrolytes
Beta-Alanine
Testosterone Boosters
Do you have access to a food scale at home and or bodyweight scale
Yes
No
Have you weighed your food before/counted your calories through a fitness app ?
Yes
No
Do you smoke or drink often
Yes
No
Occasionally
How many hours of sleep do you typically get
less than 5 hours
5-6 hours
7-8 hours
More than 8 hours
List any past injuries that I will need to be aware of in regards to your training below
Have you been diagnosed with any of the following ?
Heart Disease or stroke
High Blood Pressure
Diabetes
High Cholesterol
Asthma
Insomnia
Osteoarthritis
Testosterone Deficiency
Kidney Disease
Depression
Describe your current Lifestyle/Fitness levels
Sedentary
Lightly Active
Moderately Active
Very Active
On a scale from 1-10 how would you rate your current stress levels ? (Stress will impact your progress within the gym and can impact you eating habits)
Worst
1
2
3
4
5
6
7
8
9
Best
10
1 is Worst, 10 is Best
What are your main sources of stress ? (ex: work, school, family ect)
What types of exercise do you enjoy, or what training styles are you interested in trying ? ex: (Your favourite exercises are squatting, bulgarian splits squats. You enjoy Strength training
What type of fitness equipment do you usually have access to at home or at your gym ?( ex: dumbbells, resistance bands, treadmill/other cardio machines)
Are there specific movements/ exercises you would like to avoid ?
How do you best learn new information related to exercise ? (Please select all that apply)
Visual (seeing it done)
Auditory (hearing instructions)
Kinaesthetic (doing it yourself)
How do you prefer to receive feedback during training sessions ? (e.g., verbally in person, written on paper ect.)
Have you taken check- in Photos/progress pictures before when working with trainer in the past ?
Yes
No
Are you comfortable sending check in phots once a week ? (These photos stay between trainer and client, Check in photos are mandatory for my clients as it helps me assess their progress overtime)
Yes, I feel comfortable
No, I do not feel comfortable
Example Progress Photo Above
Are there any other concerns, questions or information you feel I should know about ?
Submit
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