New Client Application
Name *
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Email Address *
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Phone Number *
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Birthday *
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Height *
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Weight *
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Health Questionnaire
Health History *
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Check is any of the following apply to you *
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If yes to food allergies, what are they? *
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Do you have any reason to be cleared by a doctor before partaking an exercise routine? *
If yes, please describe. *
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I understand that by partaking in an exercise routine I am doing so at my own risk. *
I confirm that the information presented on this form is accurate and answered to the best of my knowledge (write yes if true) *
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Tell me about yourself. Be as descriptive and detailed as possible so I can best learn how to help you!
How would you describe your current nutrition habits? *
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What do you currently do for exercise? *
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Have you worked with a personal trainer or coach before? *
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Why do you want to work with me? What do you wish to accomplish? What do you want me to help you with? *
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Why is this goal important to you? *
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What does complete success look like to you? If you traveled into the future one year from now, what would have to happen for you to consider our time together a complete success. *
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You know what complete success is, so then what's the biggest obstacle holding you back from reaching that version of you? What do you need to make it happen? *
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How long have you felt this way? Why haven't you been able to do this on your own? *
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Imagine yourself at complete success. Describe to me what that would mean to you and how that would feel. *
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