New Client Interest Form

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Thanks for your interest in training with us! Take 5 minutes to fill out this form and we will be in touch with you within 24 hrs. This information will be used to better customize your program. We look forward to working with you!

Email *

Name *

Address

Phone number *

Age *

What is your occupation? *

What fitness program are you interested in? *

Personal Training

Sports Performance Training

Workout Plan

Nutrition Coaching

Video Call

Were you referred by one of our partnering companies? *

ES Athletes

Ashley Academy

Interested in a free phone call consultation to further discuss program options and/or goals? *

Yes

No, I know what program I want and I'm ready to start.

Why are your looking for a fitness trainer, or which best describes your goal? *

I'd like to lose weight/fat.

I'd like to gain weight/muscle.

I'd like to improve my eating and exercise habits.

I'm brand new to health and wellness, and don't know where to start.

I struggle with stress management, sleep, self-care, and other health habits.

I'm an athlete and want to improve my performance.

I need 1-on-1 coaching

I don't need 1-on-1 coaching, but I need a custom workout plan.

Required

What is your height? *

What is your current weight? *

How active are you on a daily basis? *

Very sedentary (I work in an office setting, or I don't exercise often)

Lightly active (I exercise a couple days a week)

Moderately active (I exercise 3-5 days a week, or have a job that requires me to be on my feet for majority of day)

Highly active (I exercise 5-6 days a week, or have a job that requires immense expenditure of energy)

I am an athlete

What sports do you play? *

Which of the following best describes your diet? *

Omnivore

Pescatarian

Vegetarian/plant-based

Intermittent Fasting

Vegan

Keto/Paleo/etc.

Primarily packaged or processed foods

Primarily fresh or minimally processed foods

Required

Will you be training... *

At home with adequate equipment

At home with little to no equipment

At a gym

What type of home equipment do you have? *

What gym do you exercise at? *

Does your gym have resistance bands accessible? If yes, what kind? *

Will you be available to send a quick video or attach a couple pictures of your home or gym equipment?

Yes

Clear selection

What are your preferred forms of movement or exercise? *

Weight lifting or other resistance training

Power lifting

High Intensity Interval Training (HIIT)

Group fitness classes

Pilates or yogo

Running or cycling

Walking or hiking

Sports

Workout visuals/videos

Other:

Required

Would you like nutritional guidance? *

Yes

How familiar are you with training and counting calories/macronutrients? *

Very unfamiliar

Very familiar

Do you have food allergies? If yes, please explain. *

How many days a week are you available to exercise? *

How much time do you have available to exercise during the day? *

15 minutes

30 minutes

45 minutes

60 minutes

90 minutes

Required

Have you ever had a personal trainer before and where?

Do you have any physical injuries, chronic illnesses, or other functional limitations that we should be aware of during your training? *

Do you have a history of high blood pressure? *

Yes

Please list any dietary supplements you are taking?

Do you have any sensitivities or trauma relating to discussion of calories, weight, measurement, progress photos, etc.?

Yes

I prefer not to answer

Clear selection

Submit

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