First and Last Name:
Email:
Phone Number:
Current Recess Member:
Personal Trainer:
Availability (list all days and times you're available to train):
Tell us about your goals? (Fitness, Health, Wellness, Life)
What is driving you to make a decision? Why are your goals important to you? Why now?
What do you see as your biggest obstacle in achieving your goals?
What is your commitment level? 1-10 (1 = no commitment, 10 = incredibly committed)
Current Status
Rate your stress level 1-5 (low-high)
Rate your diet 1-5 (good-bad)
Rate your sleep 1-5 (good-bad)
Rate your activity level 1-5 (high-low)
Rate your overall well-being 1-5 (good-bad)
How are you motivated? (Drill Instructor, Friendly but firm, Friendly & patient)
What’s your favorite type of workout? What about your least favorite?
List any serious injuries, surgeries, medications, issues:
Is there anything else we should know?
If you no-show for your consultation, you will be charged the full training tier session price.
Non-members must complete $1 Trial Pass prior to session