Getting Started-Personal Training
Email address *
First Name *
Last Name *
Address *
City *
State *
Zip *
Phone # *
Emergency Contact
Emergency Contact Phone #
Best Day to Meet *
2nd Best Day to Meet *
Best Time to Meet *
2nd Best Time to Meet *
Fitness Goals *
Date of Birth *
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Height
Weight
How often do you currently workout? *
What type of workouts do you normally do? Ie. run, walk, lift weights *
Have you ever worked with a personal trainer? *
Have you had surgery in the last 6 months? *
If yes to surgeries, Please give us details (dates of surgery and type)
What medication(s) are you currently taking? *
Are you currently following a specific dietary plan? Please describe. *
Please check all that may apply!
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