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Personal Training Intake Form

Help me create the perfect training plan for your goals!

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Thank you for your response. ✨

First Name(required)

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Last Name(required)

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Email(required)

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Phone number

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Date of Birth (YYYY-MM-DD)(required)

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Gender(required)

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Height(required)

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Weight(required)

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What are your main goals with personal training?(required)

Build muscle and gain strength Lose weight / fat loss Improve athletic performance Learn proper form and technique Build a consistent workout routine Increase energy and endurance Body recomposition (lose fat, build muscle) Rehab from injury or improve mobility Accountability and motivation Train for a specific event or sport Simply move more and feel better overall

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How long would you like to take to complete this goal?(required)

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What’s your biggest challenge right now?(required)

Don't know how to train properly No time to work out Don't enjoy working out Inconsistent schedule Lack of motivation Intimidated by the gym Previous injury or pain Not seeing results from current efforts Confused by conflicting fitness advice

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Do you have any injuries or limitations?(required)

Yes No

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If yes, please list them here:

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Current activity level:(required)

Not currently working out 1-2 days per week 3-4 days per week 5+ days per week

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Do you have access to a gym?(required)

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If training at home, what equipment do you have?(required)

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Time available for training:(required)

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How many days per week can you realistically commit to training?(required)

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Please list any medications or supplements you are taking:

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Any other information or questions for me?

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Personal Training Intake Form

Thank you for your response. ✨

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