Consultation Form

First Name

Last Name

Date Of Birth

Phone

Do you have and known medical conditions?

Are you currently taking any medication?

Have you had any surgeries in the past 5 years?

Family history of diabetes, heart disease or other chronic conditions?

What is your reason for training?

Have you ever had a personal trainer before?

Do you currently exercise?

How would you rate your current fitness level?

Have you every experienced and injuries related to physical activity inside or outside of the Gym?

Client's Goals

Goal - Short Term

Goal - Medium Term

Goal - Long Term

What are you main barriers to you currently achieving your goal?

How many times can you commit to training per week?

Tell me about your experience with fitness & the gym.

What fitness actives & gym equipment DO you like?

What fitness actives & gym equipment DON'T you like?

Anything specific that you’d like to add into or focus on in your fitness journey? (i.e. Learning to deadlift etc)

Do you use any kind of fitness tracking device, e.g. Apple Watch / Fitbit

Height

Weight

BMI

Body Fat %

Resting Heatrate

Blood Pressure

Waist Measurement

Hip Measurement

Are you looking for assistance and guidance with your nutrition?

Yes

Thanks for submitting!