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About
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Sign In
My Account
Cart
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Welcome
About
Results
Contact
Let’s chat!
I want to get to know you! Please complete the form below:
Name
*
First Name
Last Name
Email
*
Phone Number
Date of Birth
*
What services are you interested in?
In-Person Personal Training
Remote Coaching/Programming
Lifestyle Coaching
If in-personal training, which location?
Wicker Park (The Academy of Strength)
Westmont (Revamped Strength & Fitness)
What are your top 3 physical goals?
What are your current lifestyle goals?
Increased Energy
Increased Mental Clarity
Overall Happiness
Establish Consistency/Routine
Improved Sleep
Decreased Stress
Nutrition
Other
If other, please explain.
Describe the last time you achieved your physical and lifestyle goals.
Please describe your training/physical activity history.
What are you looking for in a trainer?
Motivation
Accountability
Expertise
Form analysis/correction
Time Efficiency
How many days per week would you like to train?
1-2
3-4
5-6
Realistically, how long are your workout sessions?
30 mins
60 mins
90 mins
Other
If other, please explain.
List 3 Short Term (3-6 months) Goals
List 3 Long Term (6+ months) Goals
How would you rate your current fitness level (1 being novice and 5 being superhero status)?
1
2
3
4
5
Have you ever worked out with a trainer prior to now?
Yes
No
If yes, please describe your experience: what went well? what didn't?
Are there any specific exercises that you enjoy performing?
Are there any specific exercises that you are uncomfortable performing?
Do you have any existing or previous injuries or medical conditions?
How would you rate your confidence in this training experience you are about to have?
Meh, I'm not sure
I'm a little nervous, but excited
I'm super pumped!
Do you foresee any potential obstacles between you and your goals?
Thank you! I’ll be in touch in next 24 hours.
