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Full name *

Best contact number *

Email *

Date of Birth

Suburb & State

What Classes are you interested in?

Classes

Semi Private PT

Fit Over 50

Bones & Groans

Online

Are you working right now? If so, what do you do?

What is your availability for training? eg days/times

How did you hear about PT to YOU?

Any health issues or injuries I should know about? (don't forget the pelvic floor!)

Describe your current fitness levels...

Your Health and Fitness goals (in 3 sentences or less) Go!

What is stopping you from achieving these goals?

As your coach, what could I do to help and support you achieve this goal?

What have you tried in the past to get to you goal? Are you currently following any particular eating plan?

What's been the biggest reason/s you haven't succeeded in the past?

What's your current stress level? How do you manage stress?

Is there anyone else involved in helping you make this decision? If so, who?

When do you want to start your health & fitness journey?

How much are you willing to invest per week to achieve your goals?

$11 - $50

$50 - $100

$100 - $200

On a scale of 1 - 10 how committed are you to achieving your goals? 1 being 'I just want to sit on the couch and watch Netflix!' to 10 being 'I'll do whatever it takes!'?

1 - I just want to sit on the couch and watch Netflix!

10 - I've bought a new sports bra & I'll do whatever it takes!

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