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Name
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Email
*
Address
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Phone Number
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What is your current fitness level?
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Beginner
Beginner
Intermediate
Advanced
Do you have any medical conditions, injuries, or physical limitations that could affect your workouts?
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Yes/No (If yes, please provide details.)
Are you currently taking any medications that might impact physical activity?
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Yes/No (If yes, please list.)
Do you have clearance from your doctor to participate in a fitness program?
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Yes
No
What are your primary fitness goals?
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Weight loss
Weight loss
Muscle Gain
Increased Flexibility
Improved Endurance
Stress Relief
What is your motivation for seeking personal coaching?
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Personal reasons
Personal reasons
Health Concerns
Upcoming Event
What results are you hoping to achieve within the next 3–6 months?
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Do you currently have a fitness routine?
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Yes/No (If yes, please describe.)
How many days per week do you typically work out?
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What types of workouts do you enjoy or prefer?
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Cardio
Cardio
Strength Training
Yoga
Pilates
HIIT
or Email Do
Do you have access to any fitness equipment at home?
*
Yes/No (If yes, please list.)
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