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Personal Coaching Consultation Form
Please fill the form below
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*
Full Name:
*
First Name
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Last Name
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*
Gender :
Male
Female
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Date of Birth:
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Date format is invalid, please check it again
The value must be greater than or equal to -21474836487
The value must be less than or equal to 2147483647
Height:
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Weight:
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*
Whats the activity level at your job:
None(seated only)
Moderate (light activity such as walking)
High (heavy labor, very active)
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Please list the physical activities that you participate in outside of the gym and outside of work:
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Are on any medications:
Yes
No
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If yes,please specify:
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Do you have any injuries:
Yes
No
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If yes,please specify:
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What additional therapies are being undertaken for the given injury:
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Are you experiencing any stresses or motivational problems:
Yes
No
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Do any diseases run in your family:
Yes
No
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Do you suffer from diabetes, asthma, high or low blood pressure:
Yes
No
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If yes,please specify:
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Are you a current cigarette smoker:
Yes
No
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*
Your current diet could be best characterized as:
Low-fat
Low-carb
high-protein
Vegetarian/Vegan
No special diet
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What following goals does best fit in with your goals:
Improved health
Improved endurance
Increased strength
Increased muscle mass
Fat loss
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What is your goal with your training:
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Are you currently excersising regulary (at least 3x per week):
Yes
No
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Have you trained with a personal trainer before:
Yes
No
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If yes what kind of training did you do:
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At what times during the day would you prefer to train:
Morning
Mid-Day
Afternoon
Evening
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How often do you want to do Personal Training a week:
Session-1
Session-2
Session-3
Session-4
session-5
Session-6
Session-7
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What are your expectations on me as your Personal Trainer:
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PT 60 Package Options:
50 timmar avtal 24 900 kr (498 kr/tim)
30 timmar avtal 15 950 kr (531 kr/tim)
18 timmar avtal 9 995 kr (555 kr/tim)
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PT 30 Package Options:
30 Sessions avtal 9 750 kr (325 kr/gång)
18 Sessions avtal 6 084 kr (338 kr/gång)
6 Sessions avtal 2 106 kr (351kr/gång)
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1. Cancellations should be made at least 24 hours in advance of a scheduled session. Sessions cancelled less than 24 hours in advance will be charged in full to the client.
2. Each session shall be 1 hour in length. Sessions will not be extended (unless time is available) due to the lateness of the client or due to interruptions caused by the client.
3. All the information on this form is correct and to the best of my knowledge. I have sought and followed any necessary medical advice. I understand that all the information given .
I agree to the above terms & conditions
I agree to the above terms & conditions
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Signature:
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