Personal Training Questionnaire

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* 1. Name:

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* 2. Email:

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* 3. Phone:

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* 4. Age:

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* 5. Gender

Male

Female

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* 6. Height and Weight

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* 7. Describe any experience you have with lifting, along with your past experience with compound movements (barbell back squat, deadlift, bench press, etc.):

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* 8. Please select your goals in working with a personal trainer:

Weight Loss

Muscle Tone

Increase Strength

Self Confidence

Sports Improvement

General Health

Personal Motivation

Other (please specify)

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* 9. How much time do you have to dedicate to working out? Please list number of days per week and amount of time each day.

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* 10. What are you looking for?

A personally curated 12 week workout plan.

A 12-week plan along with check-ins along the way to keep me accountable and on track.

In-person personal training.

Other (please specify)