Personal Training Intake Form

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Thank you for your interest in training with me! Please answer the following so that I can get a better idea of what you're looking to accomplish with personal training.

Name:
*

Email Address:
*

Birthday:
*

YYYY

Tell me about your goals and what you’re looking to get out of your personal training sessions!
*

Do you have any hobbies / extracurricular activities you like to participate in? Tell me about them!
*

Are there any repetitive movements your job requires? IE. long periods of sitting, long periods of standing, walking a lot, etc.
*

Is there anything in your medical history that I should know about? If yes, please describe.
*

Do you have any current injuries and/or limitations you’re working through? If yes, please describe.
*

Are you currently taking any medication that I should be aware of? If yes, please describe.
*

What is your desired training frequency? (how many Private Training sessions per week)
*

What equipment do you have available? *

If you prefer training in person, where would you like to train out of? *

Are you interested in virtual training? (via video call) *

yes

potentially

Are you interested in Personal Programming? (customized programs to do on your own time) *

yes

possibly

Any additional info/requests you'd like to share?

Submit

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