2026 Goals, Exercise History, Nutrition & limitations

This form is designed to gather information about you to create the most effective workout regimen and identify how we can best support your fitness goals.

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You can't out-train bad eating. We’ll help you stay on track with your nutrition if you'd like, because 80% of your results will come from changes in your eating habits. We're not fans of fad diets—you’re free to follow whatever has worked for you in the past. That said, we prefer to keep things simple by having you maintain a food journal, which we’ll review and use to help keep you accountable. This approach has worked best for the majority of our clients.
What's today's date? *
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What is your preferred name?  *
What is your legal last name? *
Cell phone/phone number?
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What is your email address? *
What do you do for work? Does it require any physical activity? *
Roughly how many hours do you work per week? *
How do you rate the importance of your health? *
What is your current activity level? *

How do you feel about being challenged in your workouts? At our facility, we meet you where you are on your fitness journey. Whether you thrive on pushing your limits or feel apprehensive about starting a new program, you’ll be in capable hands with us.

We understand that everyone has unique needs based on their injuries, conditions, and mindset. Some individuals may be ready for intense workouts, while others might require a gentler approach to accommodate their specific circumstances.

Your training will be tailored to your fitness level and personal goals, ensuring that you feel safe and supported every step of the way. Let us know how we can best assist you on your journey! You might be surprised to learn that some of our 80-year-old clients can outperform much younger individuals.

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Have you worked with a personal trainer before? If yes, please briefly share what you enjoyed about the experience and what you felt could have been improved. *
How would you consider your current body weight
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Can you briefly describe your exercise history over the past three months? What activities or workouts have you been doing during this time? *
Please list your goals and what you hope to accomplish by working with us. *
Why those goals? Why are they important to you? *

How many days per week would you like to work out with us?

We recommend training with us at least twice a week to ensure consistent progress. Training only once a week is generally not enough to see meaningful results, which is why we don’t offer that option.

However, if you are disciplined and interested in our hybrid program—where you work out with us and use our Fitness App to complete additional workouts at home or another facility—we’d be happy to explore that possibility with you.

That said, if you plan to train only once a week and do no other exercise, we may not be the right fit for you. Our goal is to help you achieve real progress, and a commitment to consistent activity is key to your success!

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Do you plan on working out on your own outside of our sessions, or will you be working out exclusively with us?If yes, how many days on your own?

If you plan to work out on your own, we recommend subscribing to our low-cost fitness app for just $14.99 per month. The app includes a variety of pre-made workouts and programs for all fitness levels. This discounted price is available to clients on training packages.

If you choose one of our subscription training options, you’ll receive free access to the app for six months, along with basic nutritional guidance to support your fitness goals.

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Are there specific body part(s) you’d like to focus on during your training with us? *

Do you currently engage in any other physical activities outside of the gym, such as golf, tennis, gardening, or others?

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Please disclose any current or past injuries that may limit your abilities or that we should be aware of.

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List any recent surgeries or procedures that you've had that we should know about? *
Do you have any previous or current medical conditions you'd like to disclose and if so how long have you had this condition(s)? i.e. Heart attacks, High BP, High A1C, etc.
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Do you take any prescribed medications for blood pressure and/or cholesterol? If so, please list the names and dosages. *
Please list any other prescribed medications you take that we should know about. *
Do you smoke or vape? If yes, how much do you use per day (e.g., number of packs)? If you have recently quit, please indicate when you quit and how much you used to smoke or vape. *
Do you currently consume alcohol? If so, how often and how many drinks per week (or per day)? *
How would you rate your sleep quality and duration (on average, how many hours per night)? *
Typically, what time do you normally go to sleep each night? Yes, sleep is important when it comes to getting in shape :-) *
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Typically, what time do you typically wake up in the morning? Yes, sleep is important when it comes to getting in shape :-)
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How do you tend to deal/cope with stress? What ways/methods do you notice that you use? e.i. stress eat, walk, drinking, vent etc. *
Can you briefly describe what a typical breakfast looks like for you? Please be as specific and honest as possible. *
Can you briefly describe what a typical lunch looks like for you? Please be as specific and honest as possible. *
Can you briefly describe what a typical dinner looks like for you? Please be as specific and honest as possible. *
About how many meals do you eat per day?
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How big would you say majority of your meals are? *
Are you currently on a diet?
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What are some of your bad eating habits? *
Would you be interested in attending a twice-a-month nutritional support group via Zoom if we offered it? *
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How often do you travel for work and/or leisure? This will give us a good understanding of how to better implement tools to help you while traveling. *
Please rate your readiness for change. *
What are your expectations of us as your personal trainer? How can we ensure you have a great experience and support you in achieving your goals? *
So we get to know you a little better, what are some of your leisure activities/what do you enjoy to do for fun? *
OPTIONAL: Share with us anything that you think that we should know about you or anything maybe we didn't ask.
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