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Join the Inside Out Fitness team
The following form will help me get to know more about you and your goals.
18
Questions
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1
Name
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First Name
Last Name
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2
How would you prefer to be contacted?
*
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Please provide email address and/or phone number
Please enter your email
Please enter your phone
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3
How long have you wanted to make changes to your lifestyle?
*
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Less than 2 months
2-6 months
6-12 months
More than 1 year
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4
How important is it for you to make these changes?
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1 being not at all important; 10 being extremely important
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1
2
3
4
5
6
7
8
9
10
Please Select
Please Select
1
2
3
4
5
6
7
8
9
10
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5
Have you ever set yourself any health and fitness related goals before and if so, what were they?
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6
Did you manage to achieve these goals?
Yes
No
Partly
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7
What do you think is the most challenging barrier you face when working towards your goals?
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8
How active is your current job?
Not active / Desk-based
Moderately active / Involves some walking
Very active / Manual labour
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9
How would you rate your current activity levels outside of work?
*
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Sedentary (Little to no daily walks or exercise)
Lightly active (Some short walks and exercise 1-3 times per week)
Moderately active (Moderate daily walks and exercise 3-5 times per week)
Very active (Daily walks and exercise 5-7 times per week)
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10
Which of the following best describes your current nutrition?
Terrible all of the time
Not great really; more bad than good
Okay through the week but terrible on weekends
Pretty good most of the time but still not seeing results
Extremely good; I track all of my food and know exactly what and how much to eat
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11
What is your present gym experience?
*
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Tick all that apply
I use fixed pin resistance machines
I use free weights
I use cardio equipment
I attend classes
I walk daily
I do home workouts
I follow a structured exercise programme
Other
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12
When it comes to the gym, exercise and movement, what do you enjoy to do?
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13
What do you find you dislike or don't enjoy?
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14
What do you feel like you need the most support with when it comes to achieving your goal?
*
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Tick all that apply
Accountability
Structure
Education
Motivation
Staying consistent
Other
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15
What are the main outcomes you would like to achieve from having Personal Training?
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16
How long would you expect it to take to achieve these outcomes?
3 months
6 months
1-2 years
3+ years
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17
How will you feel when you achieve these outcomes?
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18
Is there anything else you would like to add that you think would help me understand how you feel about health and fitness and/or your goals?
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