Online Coaching Starting Form

First name

Last name

Birthday

Month

Day

Year

Phone

Occupation

Please explain your goals and reasons for working with a coach

If anything, what has prevented you from achieving your goals in the past?

How many training sessions will you have per week?

How much time do you have per session? (Minutes)

Please state any allergies or dietry requirements

Please state any medical conditions, injuries we may need to know about when designing your training programme

Which gym are you a member of, if any?

If training from home, what equipment do you have available?

Exercise likes and dislikes?

Any strengths and weaknesses?

Please explain your current training split if you have one

Please describe in as much detail as possible your current eating habits, timings and diet. Include calories and macros if you know them

Are you happy for us to be in touch using your details?

Yes

I understand that the testing undertaken and exercises performed as part of this programme can be physically demanding and that the health screening questionnaire is designed to help me in assessing my fitness for this programme. I will let my Coach know if I have any new medical conditions, injuries or become pregnant. As a condition of my participation I accept full and complete responsibility for my participation in this programme of personal training and, where I have any doubts about my fitness, I have obtained medical approval for my participation. I agree that Emily Killick and Embody Training is/are free of all and any liability for any death, injury, illness or other problems consequent on, or subsequent to, my participation in any training programme or nutrition advice. Please sign below*

Signature

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.