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Consultation
First name
*
Last name
Date of Birth
*
Month
Day
Year
Email
*
Phone
*
Health and Medical Information
Do you have any current or past injuries?
*
Do you have any medical conditions (e.g., heart issues, diabetes, asthma)
*
Are you currently taking any medications?
*
Have you been cleared by a doctor for exercise?
*
Lifestyle & Fitness Background
How active are you currently?
*
What types of exercise do you currently do (if any)?
Have you worked with a personal trainer before?
*
What are your top 3 fitness goals?
*
Weight loss
Build muscle
Increase strength
Improve endurance
Better mobility
General health
Sports performance
Other
What areas would you like to focus on most?
*
What motivates you to start training now?
*
How many days per week are you willing to train with a trainer?
*
2 days/week
3 days/week
4+ days/week
Preferred training times:
*
Morning
Afternoon
Evening
Preferred training location:
*
Gym
Outdoor
At home
Rec centers
What’s your current weight?
*
Signature
*
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