Personal Training & Online Coaching | Consultation & Health Assessment Form
My mission is to help ladies and gents drop unwanted body fat, build muscle, boost their mind and body confidence. I don’t take just anybody for Personal Training or Coaching, as I like to make sure we are a match and good fit. The first part will be a consultation, that allows us to get to know each other more and for you to ask any questions.

Please fill out the form below and I will contact you within 24 hours to arrange a consultation or a call.
Name *
Your answer
Age *
Your answer
Gender *
Email *
Your answer
Contact Number *
Your answer
Occupation? *
Your answer
Where do you live? *
Your answer
Please tell us about your current exercise/training programme, if any. For example, Push, Pull, Legs, CrossFit, Classes, Yoga etc... *
Your answer
Are you enquiring about 1-2-1 Personal Training or Online Coaching? *
Goals *
Why are these goals important to you? *
Your answer
Do you have any injuries? *
Your answer
Weight (kg/lbs) *
Your answer
Height (ft/cm) *
Your answer
What do you want from your Coach (Brandon Hepburn) Results, knowledge, confidence, lifestyle change or other. *
Your answer
Write down 3 things you love about yourself. *
Your answer
Where do you want to be in 6 months…a year? What do you look like, feel like, do, etc.? *
Your answer
What are the biggest obstacles that have kept you from reaching goal on your own already? *
Your answer
Who do you feel like supports you? Who/what holding you back? *
Your answer
What are your priorities? *
Your answer
Describe your current state of mind to Training and Nutrition. E.g. Motivated! just need more support, structure and/or knowledge. *
Your answer
How active is your job? E.g. I sit down all day or I'm on my feet and walking all day. *
Your answer
What Gym do you use/train out of? *
Your answer
What are your favourite foods? *
Your answer
How much water do you drink on an average day? *
How much sleep do you get per night, on average? *
Tell me how you feel when you wake up in the morning? *
Your answer
On a scale of 1-10. 10 being the BEST and 1 being TERRIBLE. How are you feeling?
Digestion *
Energy Levels *
Sleep *
Stress *
Strength *
Recovery *
Have you ever tracked your food intake? (Calories or Macros) *
How many days a week would you like to workout? *
What has worked for you in the past with your Training or Nutrition? *
Your answer
Are you able to track your food intake? *
Do you have any questions for me? *
Your answer
Where did you hear about my services? *
Your answer
What day and time is best to contact you for a chat? *
Your answer
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service