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Online/ In person Coaching Enquiry Form
*Please note that I am currently studying Level 3 Personal Training qualification*
Please answer each question honestly and the best of your ability. All this information will allow me to tailor your plan specific to you.
* Indicates required question
Email
*
Your email
Name
*
Your answer
Age
Your answer
Gender
*
Female
Male
Prefer not to say
Phone number
Your answer
In the past 12 months, how often have you participated in physical activity?
*
Hardly ever or never
1-2 times a week
3-4 times a week
4+ times a week
If any, what are your barriers from physical activity
Your answer
What are your motivators?
Your answer
What is your current occupation?
Your answer
Do you have any hobbies? If so what are they?
Your answer
How many days do you want to train?
3 days
4 days
5 days
Clear selection
Any exercise preferences?
Your answer
How much do you weigh in KG?
*
Your answer
How tall are you in CM?
*
Your answer
On a scale of 1-10, how physically fit would you say you are?
*
1
2
3
4
5
6
7
8
9
10
Are there any medical conditions that I should know about that could prevent you from training? For example injuries/ heart conditions. * Please note I may not be able to offer any services depending on this* a GP note may be required before starting. If none please put N/A
*
Your answer
A copy of your responses will be emailed to the address you provided.
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