Contact Number

Email Address

Current Weight?

Desired Weight?

Injury & Health

Injuries/Illness Further Information

If you have had any major issues in the above category please list them below.

Have you had any operations?

If yes, please explain

AVAILABILITY FOR PERSONAL TRAINING

Describe the exercise?

OTHER GOALS

If you wish, you can add as much information here about your goals, ambitions & aims

How did you hear about Fitness Goose?

Performance History

Press Ups

How many in 1 set?

Barbell Squat Weight

What barbell weight would you use in a squat?

Deadlift

How heavy can you deadlift for 12 reps?

Leg Press

How heavy can you leg press for 12 reps?

Barbell Shoulder Press

How heavy can you shoulder for 12 reps?

Plank

How long can you plank for? Estimate?

Exercises Per Session

How many exercises would you do on average per session

Running 5K

What would your estimate 5k time be roughly

Running Time

Estimate - If you have to run without stopping. How long could you go today?

Please answer the questions below

Use your email address you wish to be contacted by