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AbzFitness - Pre Consultation Form
In order for me to help you achieve life-changing results you must be honest as possible and fill out this form as accurately as you can. This way I can offer you the most suitable program according to your goals.
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* Indicates required question
Email
*
Your email
Full Name(s)
*
Your answer
Contact Number
*
Your answer
How long have you been wanting to make changes to your lifestyle?
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6 Months
1-2 years
2-3 years
3 years +
How important is it for you to make these changes?
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Not Important
1
2
3
4
5
6
7
8
9
10
Very Important
Have you ever set your own goals before and if so, what were they?
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Your answer
Did you achieve them?
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Yes
No
When working towards your goals what were the main barriers you had to try to overcome?
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Time
Knowledge
How to apply knowledge
Motivation
Unsustainable process
Work/life balance
Family
Required
How would you rate your current activity levels?
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Sedentary – (Little to no daily walks, desk job little to no exercise)
Lightly active (Lightly active plus exercise 1-3 times per week)
Moderately active (Moderate daily walks/activity plus exercise 3-5 times per week)
Very Active (Highly active with walks/daily activity and exercise 5-7 times per week)
How would you rate/describe your current nutrition? (Rating 1-5 or multiple choice)
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Terrible all of the time
Not great really more bad than good
Not too bad decent through the week but go mad at weekends.
I’m pretty good most of the time but don’t see many results from that
All over it, understand calories know what and how much to eat
Explain in more detail why you have chosen that number?
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Your answer
What is your present gym experience?
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Use fixed pin weight machines
Use free weights
Use cardio kit
Use classes
Daily walks
Home workouts
None
Required
When it comes to the gym, exercise and movement, what do you enjoy to do?
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Your answer
What do you find you dislike and don’t enjoy?
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Your answer
When it comes to trying to achieve your goal, what do you feel like you need support with most?
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Accountability - Constant confirmation you're doing the right thing
Structure - What to do and when to do it
Education - Knowing why and how to apply the principles into your life
Motivation - Have someone to support you through the process
Staying consistent - Support to overcome barriers
Required
In your words, what are the main outcomes you would like to achieve from having personal training & lifestyle coaching?
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Your answer
How long would you say it would expect to achieve that?
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3 months
6 months
1 year
2 years
3 years +
Do you want to add anything else you feel would benefit my understanding of you and what you want to achieve?
*
Your answer
How did you come across AbzFitness?
*
Google search
Referral
PureGym website
Other:
A copy of your responses will be emailed to the address you provided.
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