Personal Training – Weight Training Program

Personal Training – Weight Training Program Intake

Please complete this form so your trainer can design a safe and effective weight training program tailored to you.

Full Name(Required)

Preferred Name(Required)

Email(Required)

Phone(Required)

Age(Required)

Height(Required)

Weight (optional)

Emergency Contact & Phone:(Required)

Training Goals

Primary goal (fat loss, muscle gain, energy, performance, habits, etc.)(Required)

Secondary goals (if any)

Training Schedule & Availability

Desired start date:(Required)

Days per week available to train(Required)

Preferred session length(Required)

Training Experience

Experience level (Beginner / Intermediate / Advanced)(Required)

Beginner

Intermediate

Advanced

Previous programs or styles followed(Required)

Exercises you enjoy(Required)

Exercises you dislike or avoid(Required)

Health & Lifestyle Considerations

Gym access (commercial gym / home gym / bodyweight only)(Required)

Available equipment (dumbbells, barbells, machines, bands, etc.)(Required)

Injury & Health History

Current or past injuries (location, date, severity)(Required)

Medical conditions trainer should know about(Required)

Physician clearance to exercise?(Required)

Yes

Lifestyle & Recovery

Average sleep per night(Required)

Stress level(Required)

Low

Moderate

High

Occupation & physical demands(Required)

Program Preferences

Training style preference (structured / flexible / mix)(Required)

Preference for heavy lifting, higher reps, circuits, minimal equipment, etc(Required)

Additional Notes: Anything else your coach should know

Acknowledgment(Required)

I confirm the information provided is accurate and understand that weight training involves inherent risks. I agree to inform my trainer of any changes in health status.

Client Signature(Required)

Date(Required)

Trainer Signature(Required)

Date(Required)