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Personal Trainer
Personal Trainer Free Consultation Booking
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Basic Information
First Name*:
Last Name*:
Email*:
Phone Number*:
Date of Birth*:
Age*:
Height*:
Weight*:
Gender*:
Male
Female
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Lifestyle Information
What is your occupation?*:
List physical activities participated in currently outside of exercise/gym*:
What is your current activity level?*:
What is your current activity level?
Inactive
Light
Moderate
Vigorous
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Health Information
Please list any diagnosed health conditions*:
Please list any previous or current injuries*:
Please list any current medications*:
Do you smoke?*:
Do you smoke?
Yes
No
Do you drink alcohol?*:
Do you drink alcohol?
Yes
No
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Nutritional Information
How many meals do you eat in a day?*:
Do you currently or previously track food?*:
Please describe your current diet*:
Please describe your current diet
Low Fat
Low Carb
Vegan
Vegetarian
Pescatarian
Other
If other, please describe:
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Training and Goals
Please describe your training goals*:
Do you currently exercise?*:
Do you have access to a gym?*:
Have you worked with a trainer before?*:
What current exercise equipment do you have access to?*:
Please select the days best for training in your current schedule*:
What are the best times of day for training in your schedule?*:
How often per week do you want to train?*:
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Time and Date
What day and time would work best for your initial appointment to be scheduled?*:
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