Pre Consultation Form

Please fill out this form to help me understand more about you. Once you submitted this form I will get in touch with you to arrange a free consultation call. Thank you!

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Name *

First

Last

Phone Number *

Email *

Would you like to be added to my mailing list?

• Yes Please! 🙂
• No, Thank You

What is your DOB?

What Programme are you interested in?

• Personal Training – In person or Online
• 6 Week Online Commit To Yourself
• Online Memberships
• Group Coaching
• 7 day free challenge

1. How long have you been wanting to make changes to your lifestyle?

2. How important is it for you to make these changes and why? (Rating system 1 Not Important 10 Life changing important)

3. Have you ever set your own goals before and if so, what were they?

4. Did you achieve them?

5. When working towards your goals what were the main barriers you had to overcome?

• Family
• Work
• Busy Life
• Social Life
• Other

If you selected 'Other' please specify what any other barriers you had to overcome in order to achieve your goals?

6. How would you rate your current activity levels?

• Sedentary – very little movement
• Lightly Active – 2-3 times per week light walk
• Active – Daily walks + 2 workouts per week
• Daily Walks + workout 3-4 times per week or more

7. How would you describe your current nutrition habits?

8. When it comes to the gym, exercise, and movement, what do you enjoy doing?

9. What do you find you dislike and do not enjoy?

10. When it comes to trying to achieve your goal, what do you feel you need support with the most?

• Structured and achievable plan
• Accountability
• Knowledge and how to implement it
• Other

11. In your words, what are the main outcomes you would like to achieve from having personal training?

12. How long would you say it would take to achieve your goal?

• 3 Months
• 3-6 Months
• 6-12 Months
• More Than 12 Months

13. Do you want to add anything else you feel would benefit my understanding of you and what you want to achieve?

14. How did you hear about me?

15. Why do you believe I am the right person to help you?

16. Are you ready to invest in yourself?

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