Personal Training Client Information Questionnaire

Ready to get started? Please complete our new client intake form, below.

All information received will be treated as strictly confidential. Please fill out the form completely and accurately. This information will allow me to design programs that address your needs/goals while considering your safety.

  • Personal Training Client Information Questionnaire

    All information received will be treated as strictly confidential. Please fill out the form completely and accurately. This information will allow me to design programs that address your needs/goals while considering your safety.

    **Don't have time to fill out the entire form? Scroll down to the bottom of this page and select "Save and Continue Later".

  • Section 1: About You

  • Date Format: MM slash DD slash YYYY
  • Section 2: About Your Health

  • Section 3: About Your Lifestyle

  • Please enter a number from 0 to 24.
  • 1 = Very Low, 10 = Very high
    Check all that apply.
  • Section 4: Your Fitness History

  • 1 = Worst, 10 = Best
  • Section 5: Your Nutrition

  • 1 = Very Poor, 10 = Excellent
  • Section 6: Your Exercise History

    Check all that apply.
  • Section 7: Developing Your Fitness Program

    Check all that apply.
  • Section 8: Setting Your Goals

  • Section 9: Miscellaneous Questions

    Check all that apply.
  • Section 10: Participant Release And Knowledge Of Agreement

  • I have read this Release and Terms of Agreement and I understand all of its terms. I sign it voluntarily and with full knowledge of its significance. Indicate your agreement by typing your full name.
  • Date Format: MM slash DD slash YYYY
  • This field is for validation purposes and should be left unchanged.