One on One Training Application
Please fill out the application below for one on one personal training.
This Client Assessment Form is a way for me to get to know you, your lifestyle and your specific goals as a client.
Please answer all questions as accurately as you can.


Before beginning your program, please visit your physician for standard blood work and a check-up in order to ensure that you have a clean bill of health.

This program is not intended to replace your physician’s recommendations and/or advice regarding decisions related to your health.

Full Name *
Your answer
Email Address *
Your answer
Phone Number
Your answer
Gender *
Age *
Your answer
What days of the weeks work best for you (choose all that apply) *
What time of the day would sessions work best for you? *
What are your fitness goals? Go into detail! *
Your answer
What physical shape are you in?
How committed are you to achieve your fitness goal? *
Investment: If I told you that I can get you to your fitness goals, how would you answer below. *
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