Private Fitness Trainer Client Intake Form
Personal Information
Full Name
Date of Birth
Email
Phone Number
Address
Emergency Contact
Name
Phone
Relationship
Health Information
Do you have any medical conditions or injuries?
Are you currently taking any medications?
Do you have any allergies?
Physician's Name
Fitness Goals
What are your main fitness goals?
What activities do you enjoy or prefer?
How many times per week would you like to train?
Lifestyle
What is your occupation?
How would you describe your activity level?
Sedentary
Light
Moderate
Active
Very Active
Additional Notes