Personal Training Intake Form
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Please provide your full name: *
Please provide your age: *
Please provide your phone number (eg: xxx-xxx-xxxx) *
Please provide your email address: *
What are your preferred pronouns? *
Do you have any medical conditions, previous or current injuries, or general concerns about exercise?  *
Briefly describe your motivations & goals in starting or enhancing your fitness routine (I.e. Feel better, weight loss, endurance, cardiovascular health, etc.) *
What is/are the best time(s) of day for you to train? *
Required
What are the best days of the week for you to train?  *
Required
On average, how many hours of sleep do you get a night? *
Do you have a consistent sleep schedule, or do you struggle with irregular sleep patterns? If so, what barriers do you face in maintaining a regular sleep schedule? I.e. work, stress, home life, screen time 
etc. 
 *
How would you describe your current stress levels? *
What are the main factors in your life that contribute to your stress? I.e. work life, family, schedule etc.  *
What does a typical day of eating look like for you? (I.e. How many meals a day? When do you eat? What types of food?) *
How satisfied do you feel with your eating habits and nutrition? Is there anything specific you would like to change?  *
On a scale of 1-10, how physically active are you currently?
Not Very Active
Extremely Active
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Briefly describe your exercise experience over the past few years: *
Have you ever worked with a personal trainer/coach? What was that experience like for you? *
Briefly describe what barriers you have faced in starting or maintaining a fitness routine: *
On a scale of 1-10, how ready are you to make positive & long lasting changes to your fitness routine? *
Not Ready
Extremely Ready
Is there anything else you would like to share regarding your fitness routine, lifestyle, questions/concerns, etc.? *
Which of the following services are you interested in pursuing? *
Required
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