Consultation Form for Personal Training in London | An Exclusive Personal Training Team in London

Please fill out this 'new client consultation form' when requested

Name
FirstLast
Date of birth
Email
Mobile number
Occupation
Employer
Height
Weight
Emergency contact name & mobile
What injuries do you have?
Do you suffer from any of the following
- ME
- High blood pressure
- Low blood Pressure
- Diabetes
- Disordered eating
- BDD
- ADHD
- Raised Cholesterol
- Anxiety
- Liver or Kidney conditions
- Digestive problems
- Any heart condition
- Epilepsy
- Hernia
- Ostereoperosis
- Athritus
- Asthma
- Cramps
- Muscular pains
Do you smoke?
- No
- Occasionally
- 40+ a week
How much do you drink?
- Occasionally
- 10+ units most weeks
- 25+ units most weeks
What medications are you on?
Do you have any infectious deseases?
- No
- Yes
Have you been recently hospitalized?
- No
- Yes
Have you recently had surgery?
- No
- Yes
Are you pregnant?
- No
- Yes
Waiver of Liability: Please read.*
We (Dan Roberts and his affiliated Personal Trainers) assume no liabilty for persons injured during the training process. If any medical or other conditions arise that could affect your training with us, you shall let other us know immediately. If you have any doubts, please consult your doctor prior to physical activity. All exercise, nutritional and well-being advice given to you by any persons associated with Dan Roberts training Ltd, it is taken at your own risk. By typing your name and today's date above you agree by these terms. This is required. Please type your full name and date
What are your primary goals?
What other fitness and wellbeing goals do you have?
Why are these goals important to you?
What training do you currently do now?
The more details..the better!
What are your expectations?
Have you used Personal Trainers before?
- No
- Yes
Which exercises do you love?
Which exercises do you dislike?
Do you want help with nutrition?
- No thank you
- Maybe
- Definitely
Do you have a prefered location
- Outside in parks
- Home
- At a private fitness studio
- I don't mind
What is your availability?
What services are you interested in?
- Our 'Regular' Personal Training programme
- 100 day Body Transformation package
- Learn to Fight package
- Extreme Weight Loss Package
- Online Personal Training
- Extreme Fitness Holidays / VIP Bootcamp
- Coprorate Fitness Training
- International Personal Training
- Personal Training with an Elite Trainer
- Private Training with Dan Roberts
Your questions for Dan & his Team.

Personal Training – Consultation Form

Please fill out this 'new client consultation form' when requested