Personal Training Questionnaire – christeldeklerk.com

Thank you for scheduling a workout session!

In order to get ready for our first time working together, please complete the form below.

Before our first workout we'll have a consultation of about 15 - 30 minutes and then we'll jump into training, please allow extra time for the consultation.

Your form could not be saved. Please try again.

Your questionnaire submission has been successful.

Program Questionnaire

Enter your FIRST NAME

Enter your LAST NAME

Enter your EMAIL

Enter your HEIGHT (in CM)

Enter your WEIGHT (in KG)

Enter your AGE

Enter your GENDER

What are your goals you're trying to achieve?

Please be specific, a certain look / weight / capability to perform something etc

Do you have any INJURIES?

Are you mostly Sedentary, Lightly Active, Active, or Very Active?

SEDENTARY: Bank taller, desk job. LIGHTLY ACTIVE: Teacher, Salesman. ACTIVE: Waitress, Mailman. VERY ACTIVE: Heavy physical activity, Carpenter

What type of Training Style do you enjoy?

Eg. Weight Training, Cardio Based, Body Weight Based

What is your current cardio routine?

What is your gym experience and how long have you been training?

Eg. Beginner, Intermediate (6 months or more), Advanced (1 year or more)

How many days per week can you train?

What is the total time you spend exercising?

This is weight training and cardio combined

How intense do you workout?

LIGHT: Hold a conversation while working out. MODERATE: You're breathing hard and challenging yourself. DIFFICULT: You cannot hold a conversation & have a constant elevated heart rate

Do you have any further comments for me?

We use Sendinblue as our marketing platform. By Clicking below to submit this form, you acknowledge that the information you provided will be transferred to Sendinblue for processing in accordance with their terms of use

Opt-in

I agree to receive your newsletters and accept the data privacy statement.

You may unsubscribe at any time using the link in our newsletter.