Consultation Form
Please fill in the below with as much detail as possible. All information will be confidential.
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Full Name *
Email *
Mobile *
Age *
Height *
How many hours of sleep do you get on average a night?
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How many litres of alcohol do you consume a week?
Do you smoke?
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Do you have any medical conditions, previous medical history, asthma, injury's or pains that I should be aware of?
Are you currently on any medication? If yes please try to state which.
Do you currently exercise? If yes, please explain what you do and how often. For example, what style of exercise, how many times a week and for how long.
How would you describe your current knowledge of exercise and fitness training?
What does your current diet look like? Please try to explain a typical day of eating.
What is your main reason for seeking an online coach?
Which would you say is your main goal?
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If any, what would you say are the main barriers to reaching your fitness goals?
Are there any exercises you would love to include in your programme/ any that you would prefer not to include?
How long are you looking to join my team for?
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What is your preferred method for me to initially contact you?
Terms & Conditions

1. CANCELLATION NOTICE

If you wish to end your online coaching with me, I require one months notice prior to you wishing to cancel. If you cancel with less than one months notice, you will be charged in full for that months package.

2. PAYMENTS 

Payments must be made in advance via direct debit to the trainer through Kahunas at the start of every monthly block. All money paid will be non-refundable but, under certain circumstances, may be referred to the following month. 

4. 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.

I have read, understand and agree to the above terms and conditions
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Other thoughts or comments (optional)
Thank you for filling in this form! This will help to give me a great understanding of who you are and what you're looking for, and subsequently how I can best help you!            
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