Name
*
First Name
Last Name
Email
*
Phone
*
(###)
###
####
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
How did you hear about StrongHER Training?
Word of Mouth
Online Search
Social Media
Other
Pop-Up Event
Emergency Contact
*
Emergency Contact Phone
*
What is your current fitness level?
*
Beginner
Intermediate
Advanced
Do you currently exercise? If so, what does your routine look like?
*
Have you ever worked with a personal trainer before?
*
Yes
No
What types of workouts do you enjoy (e.g., strength training, cardio, HIIT, yoga)?
*
Are there any exercises you dislike or prefer to avoid?
What are your top 3 fitness goals?
*
What motivates you to stay consistent with fitness?
*
Do you have a specific timeline for achieving your goals?
*
How many days per week can you realistically commit to training?
*
1-2
3-5
5+
What equipment do you have access to? (dumbbells, resistance bands, gym, etc.)
*
Do you have any medical conditions, injuries, or physical limitations?
*
Are you currently taking any medications that may affect your workouts?
*
Have you been cleared by a doctor to participate in physical activity?
*
Yes
No
Do you have any respiratory or cardiovascular conditions?
*
Any recent surgeries or past injuries I should be aware of?
*
What do you expect from me as your trainer?
*
How do you prefer to receive feedback and motivation?
*
Is there anything else you'd like me to know before we start?
Signature & Agreement
*
By signing below, I acknowledge that all information provided is accurate to the best of my knowledge. I understand that I should consult a physician before beginning any new fitness program.
First Name
Last Name
Date
*
MM
DD
YYYY
