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Fitness Profile
New Client Discovery
1
Contact Info
2
Goals
3
Experience
4
Nutrition
5
Exercise
6
Final Details
So, Why Are you Here...?
Congratulations on taking your next step in improving your health, fitness, and nutrition! Before we have our first visit (complimentary), please complete this quick form. This will maximize our time and effort together when we meet.
First Name
*
Last Name
*
Phone
*
Email
*
Address
What are your top 3 health and fitness goals?
*
How important are these goals to you?
*
10 - Extremely important
9
8
7
6
5
4
3
2
1 - not important at all
Why are these goals important to you?
*
Have you tried to achieve these goals before? If yes, what was your success/failure rate?
*
When was the last time you participated in a consistent exercise program? How successful were you?
*
Have you worked with a trainer before? If yes, how was that experience?
*
What do you feel you need to improve with your nutrition? (Check your top 3)
*
portion control
carbohydrate intake
meal consistency
more protein
eating out vs. cooking
binge eating
alcohol consumption
late night snacking
other (specify below)
What other areas do you need to improve with your nutrition?
What makes it difficult for you to exercise on a regular basis?
*
knowing what to do
staying motivated
discipline
accountability
intimidation
boredom
making time
other (please specify below)
What else makes it difficult for you to exercise on a regular basis?
How many days per week can you realistically exercise (with or without a trainer)?
*
2 days per week
3
4
5
How will you know our fitness program is a success for you?
*
Is there anything else you would like us to know before we meet?
*
How did you learn about Renegade Personal Training and Fitness?
*
I was a previous client
I found your website
I’m on your email list
Referred by someone else
Drive By
Other
If we haven’t talked yet, how would you like me to contact you to schedule our first visit?
*
phone
email
either
