Personal Trainer New Client Health History & Training Goals Intake Form
Full Name
· · ·
Email Address
· · ·
Phone Number
· · ·
Submit
The Personal Trainer New Client Health History & Training Goals Intake Form is an essential tool for fitness professionals onboarding new clients. It collects vital personal information, emergency contacts, medical history, current medications, past surgeries, and physical limitations—everything a trainer needs to design a safe, effective, and personalized workout program.
This form is ideal for personal trainers, gym owners, fitness coaches, and wellness studios who want a professional and thorough intake process. By capturing comprehensive health data upfront, trainers can minimize injury risk, tailor exercise programming, and demonstrate a high standard of client care from day one.
With a customizable digital format, you can easily add your branding, adjust questions to match your specialty, and securely collect responses online. Replace paper forms with a streamlined digital intake process that saves time and keeps client data organized and confidential.
4Pages
38Questions
~13minTo complete
FreeNo credit card needed
Field types
Long Text ×7
Dropdown ×7
Yes / No ×5
Multiple Choice ×4
Short Text ×3
Phone ×2
Date ×2
Full Name
Email
Single Choice
Address
number
ranking
termsandconditions
Signature
Questions in this template
Free template
The exact questions included — customize any of them to fit your needs.
Page 1Personal Information9 questions
Personal Information
1
Full Name
*Full Name
2
Email Address
*Email
3
Phone Number
*Phone
4
Date of Birth
*Date
5
Gender
*Single Choice
6
Home Address
Address
7
Emergency Contact Name
*Short Text
8
Emergency Contact Phone Number
*Phone
9
Emergency Contact Relationship
*Short Text
Page 2Health & Medical History11 questions
Health & Medical History
Please answer the following questions honestly. All information is kept strictly confidential and helps us design a safe, effective program for you.
1
Current Weight (lbs/kg)
*number
2
Height
*Short Text
3
Have you been diagnosed with any of the following conditions? (Select all that apply)
*Multiple Choice
4
Are you currently taking any medications or supplements?
*Yes / No
5
If yes, please list all medications and supplements
Long Text
6
Have you had any surgeries or hospitalizations in the past 5 years?
*Yes / No
7
If yes, please provide details including dates and procedures
Long Text
8
Do you have any injuries, chronic pain, or physical limitations we should be aware of?
*Yes / No
9
If yes, please describe the injury/limitation and any movement restrictions
Long Text
10
Has a physician ever advised you against exercise?
*Yes / No
11
Do you experience dizziness, chest pain, or shortness of breath during physical activity?
*Yes / No
Page 3Current Lifestyle & Nutrition7 questions
Current Lifestyle & Nutrition
1
How would you describe your current activity level?
*Dropdown
2
Describe your current or most recent exercise routine (types of exercise, frequency, duration)
Long Text
3
How would you rate your current diet?
*Dropdown
4
Do you have any dietary restrictions or preferences? (Select all that apply)
*Multiple Choice
5
If you have food allergies or other dietary needs, please specify
Long Text
6
How many hours of sleep do you typically get per night?
*Dropdown
7
How would you rate your current stress level?
*Dropdown
Page 4Training Goals & Availability11 questions
Training Goals & Preferences
1
What are your primary fitness goals? (Select all that apply)
*Multiple Choice
2
Please describe your goals in more detail, including any specific targets or timelines
Long Text
3
Rank your top 3 goals in order of priority
*ranking
4
What days are you available to train? (Select all that apply)
*Multiple Choice
5
What time of day do you prefer to train?
*Dropdown
6
How many sessions per week are you interested in?
*Dropdown
7
Where do you prefer to train?
*Dropdown
8
Is there anything else you'd like your trainer to know before your first session?
Long Text
9
I confirm that the information provided is accurate to the best of my knowledge. I understand that my trainer is not a medical professional, and I will consult my physician before beginning any exercise program if I have any medical concerns. I accept full responsibility for my health and safety during training.
*termsandconditions
10
Client Signature
*Signature
11
Date Signed
*Date
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