mail@jospaullfitness.uk
07796 710855
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Home
About Me
Packages
Blog
Testimonials
Contact
Home
About Me
Packages
Blog
Testimonials
Contact
Consultation
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Consultation
Personal Details
Name:
*
Email:
*
Address:
Date Of Birth:
*
Telephone:
*
Job Role:
Details of journey to work:
Work start time:
Work finish time:
Stress level of position:
(between 1-5 with 5 being highest)
Nutrition
What do you eat for breakfast?:
What do you eat for lunch?:
What do you eat for dinner?:
Do you snack? If so, when? What on?:
Do you get your 5-a-day?:
Please select...
Yes
No
How many days a week do you eat out / have takeaway?:
How much water do you drink daily?:
How many days a week do you drink alcohol?:
Out of those, how many times do you drink more than 2 glasses?:
Do you drink caffeine? How much?:
Lifestyle
What time do you go to bed?:
What time do you get up?:
Do you smoke? If so, how many?:
Other
Do you have any injuries, if so details?:
Are you on any medication?:
Are you pregnant?:
Please select...
Yes
No
What is your current UK dress size?:
Anything else you feel I should know?:
How many times a week would you like personal training?:
Please select...
1
2
3
4
5+
Exercise
Please summarise your exercise history:
(please include likes / dislikes)
Goals & Targets
What are you hoping to achieve from personal training?:
Please be as specific as possible – SMART (Specific / Measurable / Achievable / Realistic / Timebound)
Submit Consultation Form
Thank you. I'll be in touch soon :)