ERA VIRTUAL TRAINING - INTAKE FORM

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Achieve your fitness goals with expert online personal training. Customized workout plans, nutrition guidance, and 1-on-1 coaching—anytime, anywhere ---- ERA VT ANIME INQUIRIES FILL OUT FORM AND ANSWER LAST QUESTION

Email *

Section 1: Physical Metrics and Background

1. Full Name

2. Age

3. Height

4. Current Weight (lbs/kg)

Section 2: Goals and Fitness Status

5. Goal Weight (lbs/kg)

6. Primary Fitness Goal (Be descriptive as possible)

7. Current Fitness Level (BE HONEST; NO SHAME)

Beginner (New to structured exercise)

Intermediate (Consistent training for 6+ months)

Advanced (Trained rigorously for years)

Clear selection

8. How many days per week are you realistically able to train? (Crucial for results)

2 days

3 days

4 days

5 days

6 days

Clear selection

Section 3: Training Preferences and Constraints

9. What type of training do you prefer/need?

Strength Training

Cardio

Bodyweight/Calisthenics

High-Intensity Interval/Circuit based

Mobility

Other:

Clear selection

10. Where will you be doing workouts?

Commercial Gym (Crunch/Planet/Lionheart/etc.)

Campus Recreational

At home/Home gym

Other:

Clear selection

11. What time do you prefer to workout?

Early Morning 5:00am - 8:00am

Mid Day 9:00am - 12:00pm

Evening 1:00pm - 4:00pm

Night 5:00pm - 9:00pm

Other:

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Section 5: Pricing

Programming includes in-person training accompanied by paid 24/7 access gym facility with the option to add biweekly grocery list; recipes, and more; $35 value per 30 minute training session; prices vary on duration.

Section 4: Health, Nutrition, and Next Steps

12. Do you have any current or recurring injuries (past or present)? CRITICAL for Safety

13. Please list any dietary restrictions, allergies, or food preferences.

14. Are you interested in a complimentary basic nutrition guidance package (macros & caloric goal)? *Extra +$50 fee*

Yes

Other:

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In-Person Costs

2 workouts per week // 8 workouts monthly: $280

3 workouts per week // 12 workouts monthly: $420

4 workouts per week // 16 workouts monthly: $560

5 workouts per week // 20 workouts monthly: $700

6 workouts per week // 24 workouts monthly: $840

Clear selection

Basic Online Programming - Monthly Installments

Beginner $25 (3 days a week // 12 workouts)

Intermediate $75 (4 days a week // 16 workouts // Progress Pics // Monthly Check-In)

Advanced $100 (5-6 days // 24 workouts // Macro Tracking // Progress Pics // Bi-weekly Check-In)

Clear selection

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