Service Inquiry

Fill in the form below to let us know which service you're interested in

and how we can help - we'll get back to you as soon as possible.

First name

Last name

Phone number

Email

Which service are you interested in?

Add a message or tell us more about what you need

Health History

Do you have any current or past injuries we should be aware of?

Yes

No

If answered "Yes" to previous question please explain. If "No" put N/A.

Do you have any medical conditions that may affect your ability to exercise? (e.g., heart condition, diabetes, high blood pressure)

Yes

No

If answered "Yes" to previous question please explain. If "No" put N/A.

Are you currently taking any medications that may affect your training?

Yes

No

If answered "Yes" to previous question please explain. If "No" put N/A.

Have you been cleared by a physician to participate in physical activity?

Yes

No

N/A

Are you pregnant or postpartum?

Yes

No

N/A

Fitness Background

What is your current fitness level?

Beginner

Intermediate

Advanced

How long have you been exercising consistently, if at all?

Have you worked with a personal trainer before?

Yes

No

Fitness Goals

What is your primary fitness goal?

Lose weight/ Fat Loss

Tone Up/ Body Recomp

Overall Health

How motivated are you to reach your goals on a scale of 1–10?

Current weight?

Height

What is your target weight or body goal, if applicable?

What has prevented you from reaching your goals in the past?

Nutrition & Lifestyle

How would you describe your current eating habits?

How many hours of sleep do you get on average per night?

Best Value Meal Prep Questions

****ONLY ANSWER IF CHOOSING BEST VALUE TRAINING PROGRAM***

Do you have any food allergies or dietary restrictions?

Are there any foods you strongly dislike or refuse to eat?

Are there any foods you love and want included?

Do you follow any specific diet? (Vegan / Vegetarian / Keto / Halal / No preference)

Short answer

How many meals a day works best for your schedule? **3 max**

Short answer

Would you like snacks included in your plan?

Scheduling & Availability

Are you booking for in-person or online training?

In Person

Online

What day(s) and times are you generally available? N/A if online training

How many days per week are you available to commit to working out? **Online Clients Only**

2

3

4

5

Do you have access to home/community gym?

Yes

No

Do you have access to a gym or any home equipment? *Online clients only*

Yes

No

Agreement

Have you read and agreed to the training policies?

Yes

No

Signature

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