Personal Training

Personal Training

Questionnaire
Full Name*

First NameLast Name
MaleFemale
Date of Birth*

MonthDayYear
Height
cm
Weight
KG
What do you do for a living?
none(seated only)Moderate (light activity such as walking)High (heavy labor, very active)
Do you follow a regular working schedule? Mornings / 9-5 / Afternoons / Evenings
RarelyA few times a yearA few times a monthWeekly
Do you have any regular physical activities or strenuous hobbies?
Do you have any diagnosed health problems?
If you are on any medications, please list them.
If you have any injuries, please list them.
What additional therapies are being undertaken? eg: Chiro, Physio, Massage etc
YesNo
YesNo
Please list:
YesNo
low-fatlow-carbhigh-proteinVegetarian/VeganNo special diet
What is your goal with your training?
Why?
Increase General FitnessBuild StrengthBody Toning / ShapingIncreased muscle massWeight / Fat loss
How often are you willing to train a week to reach your goal?
YesNo
What kind of training did you do?
YesNo
How often do you want to do Personal Training a week?
Please Choose
Early Morning (6-8am)Morning (7-10am)Mid-Day (10am-2pm)Afternoon (2-6pm)Evening (5-7pm)
What are your expectations/needs on me as your Personal Trainer?
Individual sessions ongoing ($130/session)5 Sessions for $625 ($125/session)10 Sessions for $1150 ($115/session)
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (+61 000 000 000).
1.) CANCELLATIONS

Cancellations should be made at least 24 hours in advance of a scheduled session. Sessions cancelled less than 24 hours in advance will be charged in full to the client.

2.) LATE ARRIVALS

Each session shall be 50 minutes in length. Please arrive 10 minutes early to your session to adequately warm up as outlined in your program and pracited together during our first few sessions. Sessions will not be extended (unless time is available) due to the lateness of the client or due to interruptions caused by the client.

3.) ALL THE INFORMATION I HAVE GIVEN IS CORRECT

All the information on this form is correct and to the best of my knowledge. I have sought and followed any necessary medical advice. I understand that all the information given will be kept confidential.
YesNo
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