Elite In-Home Personal Training 
Pre Consultation Questionnaire

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Name(s):  
Age(s):
Height(s):
Weight(s):
Goal(s):
Cell Phone Number:
Work Phone Number:
Phone Number You Prefer:
Best Time To Contact:
Mailing Address:


What is your profession? Your spouseâs profession?

How long have each of you worked in your professions?  In your specific industry?

Is your schedule flexible, or is it set and predictable?

Do you currently own/have access to exercise equipment?

Do you have any health conditions that may become present during exercise?

What experience do you have with exercise, sports, and/or any other health and fitness related activities and to what extent?

Have you worked with a personal trainer before?

What was the motivating factor in the decision to contact Elite In-Home Personal Training?

Do you travel frequently? If so, what is the length of your average trip?

When were you in the best condition of your life? What type of conditioning did you attain at that time? (For example: athletic, muscular, long and lean, toned)

On a scale from 1-to-10, how important is reaching your health and fitness goals in a timely fashion in comparison to all of the other things you have going on in your life?

In the end, proper nutrition can account for up to 70% of the level of fitness you are able to reach.  Are you willing to stick to fairly regimented meal plans until you reach your goals?

What hobbyâs or activities do you participate in?

Are there any other health issueâs that I need to know about before we begin?

How did you hear about Elite In-Home Personal Training?

From a friend           Magazine feature         Craigslist          MySpace       Other



































Elite In-Home Personal Training
© 2008 Deytyme Corp.
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This information and other information on this site is intended for general reference purposes only and is not intended to address specific medical conditions. This information is not a substitute for professional medical advice or a medical exam. Prior to participating in any exercise program or activity, you should seek the advice of your physician or other qualified health professional. No health information on this site should be used to diagnose, treat, cure or prevent any medical condition. These statements have not been evaluated by the Food and Drug Administration. Products advertised on this site are not intended to diagnose, treat, cure, or prevent any disease.