Let’s Get Started! Please fill out the form below so I can learn more about you. Name * First Name Last Name Age * Date of Birth * MM DD YYYY Height * (ex. 5'3", 5 ft, 3 in, etc.) Phone Number * (###) ### #### Email * What are your current fitness goals? * Choose all that apply. Lose Fat Gain Muscle Lose Weight What is the biggest obstacle that keeps you from reaching your goals? * Choose all that apply. I lack the motivation to go to the gym. I need more structure in my routine. I don't know what I should be eating. I don't know where to begin. I'm scared that my form is bad. Have you had personal training before? * Yes, I have had personal training before, either online or in person. No, I have not had personal training before. If yes, when and for how long? If yes, was your training online or in-person? Online In-Person How many days a week are you currently active? * What does that current activity look like? * (Choose all that apply) Walking Cardio Strength Training Outdoor Activity Sports None Other How would you describe your current level of fitness? * Beginner Intermediate Advanced How many days a week can you CONSISTENTLY train? * What days of the week would you like to train? (Choose all that apply.) Monday Tuesday Wednesday Thursday Friday Saturday Sunday How much time can you devote to each workout? * (1 Hour, 30 minutes, etc.) Do you have access to a gym? * Yes, I do have access to a gym. No, I do not have access to a gym. If not, what equiptment do you have access to? Do you have any injuries and/or health concerns? * Yes, I do. No, I don't have any injuries and/or health concerns. If so, please list them here. Thank you for taking the time to complete this questionnaire! You're almost done now. Is there anything else you would like me to know? Thank you!
