New Client Intake Form
* Required
Personal Information
Client Name (First & Last)
*
Your answer
Age
*
Your answer
Primary Phone #
*
Your answer
Alternative Phone #
Your answer
E-mail Address
*
Your answer
Preferred Method of Communication
*
Call
Text
Email
Preferred Facility
*
Choose
Clareview Community Recreation Centre
Commonwealth Community Recreation Centre
Kinsmen Sports Centre
Londonderry Fitness & Leisure Centre
Mill Woods Recreation Centre
Terwillegar Community Recreation Centre
The Meadows Community Recreation Centre
Client Availability
*
Please list days and times that you are available to meet with a personal trainer.
Your answer
Services
*
Which Fitness and/or Nutrition Services are you interested in?
Exercise Consultation
Private Personal Training (1-on-1)
Semi-Private Personal Training (2-4 clients)
Nutrition Consultation
Required
City of Edmonton Facilities
*
What is your experience with City of Edmonton facilities? What City of Edmonton facilities/amenties/services you have utilized and for which activities?
Your answer
Fitness/Exercise History
*
Please provide a brief history outlining your experience with fitness centres and/or exercising
Your answer
General Fitness Goals
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What are your fitness goals are, why you are interested in a personal trainer and what are you hoping to get out of your personal training sessions?
Your answer
Personal Training Styles
*
What kind of trainer are you most interested in, and what kind of person would you like them to be?
Your answer
Trainer Request
Do you have a specific personal trainer you would like to request?
Your answer
How did you hear about us?
*
City of Edmonton Website
Staff at a City of Edmonton faiclity
E-Active Guide
Referral/Friend
Other
Required
Emergency Contact Information
Name (First & Last)
*
Your answer
Relationship
*
Your answer
Primary Phone #
*
Your answer
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