Training Consultation Questionnaire  
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Name? *
Gender *
Age? *
Phone number? *
Email address? *
Height? *
Weight? *
What's the activity level at your job? *
Do you follow a regular working schedule, do you work days, afternoon or nights?
Please list the physical activities that you participate in outside of the gym and outside of work:
Are you experiencing any stresses or motivational problems? *
Do you suffer from diabetes, asthma, high or low blood pressure? *
If you have any injuries, please list them.
What additional therapies are being undertaken for the given injury?
Are you a current cigarette smoker? *
Your current diet could be best characterized as: *
Required
Please rate your readiness for change. *
What following goals does best fit in with your goals? *
Required
What is your personal goal with your training? *
Timeline for achieving your goal. *
Required
How many hours a week are you currently exercising? *
Have you trained with a personal trainer before? * *
If yes, what kind of training did you do?
At what times during the day would you prefer to train? *
How often do you want to do Personal Training a week? *
session
sessions
What are your expectations on me as your Personal Trainer? *
How did you hear about “Tailormade Training”? *
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