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First name

Last name

Phone

What are you interested in?

One-on-one Personal Training

Nutrition

Personal Training & Nutrition

Have you trained with a personal trainer before?

Yes

What type(s) of exercise have you done recently? (e.g weight training, running, group classes, etc)

On a scale of 1-10, how would you rate your current fitness level?

What is your occupation/daily activity level? (sedentary, light, moderate, high)

Nutrition: what does a day of eating look like for you? Any dietary preferences or restrictions?

What are your short-term fitness goals? (next three months)

What are your long-term goals? (6 months to a year)

What is your motivation for training and/or nutrition? (e.g mood/stress, appearance, performance, health, weight loss, strength)

How many times per week are you willing/able to train?

Preferred training times (morning/afternoon/evening)