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RebelZen Online Training
Thank you for considering RebelZen to help you accomplish your fitness goals. Online training is the most effective and affordable way for me to offer my services. Please fill out the following form and I'll get back to you within 24 hrs.
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Email
*
Your email
Full Name
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Your answer
Age
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Your answer
Gender
*
Male
Female
Prefer not to say
Phone number
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Your answer
Preferred weekly "check-in" method to discuss how your program is going
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Email
Phone Call
App messenger/text
Zoom or Google Meet
Please make note of any medical conditions, symptoms of your conditions and, all medications that you take. (Please be specific with medications)
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Your answer
Please make note of any surgeries, injuries, or limitations in movement.
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Your answer
Have you ever had a personal trainer before?
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Yes
No
Required
If yes, briefly describe what went well and what did not go well.
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Your answer
Currently, what do you do for activity? How long per session? How many times per week?
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Your answer
What is a short-term fitness goal? (Around 1-3 months)
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Your answer
What is your favourite place that you have travelled to?
Your answer
What equipment do you have access to?
Your answer
How many days a week do you want to workout
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3 days
4 days
5 days
Approximately how long would you like your workouts to last?
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Short- 30-45 mins max
Medium - around 1 hour give or take 15mins
Long - I can spend up to 1.5-2hrs/workout
What date would you like to start?
MM
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DD
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YYYY
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