Training Application | Foundry Health and Performance

1-On-1 Training Application

Training With Collis

Please complete the application below to apply for the next available slot for 1-on-1 Personal Training. If you’re still unsure about joining, please click the button below to schedule a call to determine if you’re the right fit. Thank you.

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1-On-1 Training Application

Basic Infomation

Full Name(Required)

First Last

Email(Required)

Gender

Male

Female

Date of Birth(Required)

MM slash DD slash YYYY

Age

Height (Feet)

(Inches)

Weight (lbs)

Lifestyle Information

Occupation

Whats the activity level at your job?

None (seated only)

Moderate (light activity such as walking)

High (heavy labor, very active)

Do you follow a regular working schedule, do you work days, afternoon or nights?

How often do you travel?

Rarely

A few times a year

A few times a month

Weekly

Please list the physical activities that you participate in outside of the gym and outside of work.

Medical and health information

If you have any diagnosed health problems list the condition(s).

If you are on any medications, please list them.

What additional therapies are being undertaken for the given health problem(s)?

If you have any injuries, please list them.

What additional therapies are being undertaken for the given injury?

Are you experiencing any stresses or motivational problems?

Yes

Has anyone of your immediate family developed heart disease before the age of 60?

Yes

Do any diseases run in your family?

Yes

Do you suffer from diabetes, asthma, high or low blood pressure?

Yes

if yes please list:

Are you a current cigarette smoker?

Yes

Your current diet could be best characterized as:

low-fat

low-carb

high-protein

Vegetarian/Vegan

No special diet

Goals

Please rate your readiness for change.

What following goals does best fit in with your goals?

Improved health

Improved endurance

Increased strength

Increased muscle mass

Fat loss

What is your goal with your training?

Why?

TImeline for achieving your goal.

8 Weeks

16 Weeks

24 Weeks

32 Weeks

40 Weeks

1 Year

How often are you willing to train a week to reach your goal?

Please rate your motivational level to do what it takes for reach your goal.

Are you currently excersising regulary (at least 3x per week)?

Yes

Have you trained with a personal trainer before?

Yes

If yes what kind of training did you do:

At what times during the day would you prefer to train?

Morning

Mid-Day

Afternoon

Evening

How often are you willing to train a week to reach your goal?

What are your expectations for me as your Personal Trainer?

Please Read The Following Terms and Conditions.

Terms & Conditions(Required)

I agree to the Terms & Conditions below:

1.) CANCELLATIONS

Cancellations should be made at least 24 hours in advance of a scheduled session. Sessions cancelled less than 24 hours in advance will be charged in full to the client.

2.) LATE ARRIVALS

Each session shall be 1 hour in length. Sessions will not be extended (unless time is available) due to the lateness of the client or due to interruptions caused by the client.

3.) ALL THE INFORMATION I HAVE GIVEN IS CORRECT

All the information on this form is correct and to the best of my knowledge. I have sought and followed any necessary medical advice. I understand that all the information given will be kept confidential.

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