CLIENT APPLICATION
Email address *
Name
Your answer
Email
Your answer
Cell phone number
Your answer
What is your goal for training with me?
Your answer
Tell me about your exercise history (i.e. what have you done, what is your favorite) *
Your answer
What does your ideal self look like. Please describe that person *
Your answer
If applicable (i.e. not an online client) what are the best times and days for you to train? *
Your answer
Please answer the following
yes
no
not sure
I am over the age of 45 and a man or I am over the age of 55 and a woman
I have a family history of heart disease
I smoke cigarettes
I have a sedentary lifestyle
I am obese
I have hypertension
I have dyslipidemia
I have diabetes
I want to get to know a little about you in the next few questions! First question, why did you decide to chose me as a trainer? (can write N/A if not applicable)
Your answer
I am a PhD student, research assistant, and also personal train. So needless to say I am a very busy person. Because of that I like to take motivated clients, so tell me why you would make a great client?
Your answer
What is your favorite movie?
Your answer
What is your favorite book?
Your answer
What is your favorite quote and who said it?
Your answer
What is your favorite food?
Your answer
Where are you originally from and where do you live now?
Your answer
Have you had a trainer before? If so tell me about your experience
Your answer
Do you have a favorite sports team? If so who is it?
Your answer
Do you have any fun/cool/awesome facts about yourself you would like to share?
Your answer
I love super hero movies, coffee, competing in any kind of fitness event (powerlifting, half marathons, and triathlons) witty banter, and hiking (which often leads to staring at bodies of water and pondering life). I write just about every week, whether it's for research or for a blog. I'm ridiculously passionate about helping people live healthier lives (hence the PhD). I enjoy seamlessly transitioning from intellectual to ridiculous conversation and I like spending my mornings reading. Anything else you want to tell me about you? *
Your answer
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