New Client Intake Form | Janina's Fitness Center | Brea, CA
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Personal Training Intake Form

I shall work very hard with you to help you meet your fitness goals! Your health and fitness are very important to me.

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I’m your dedicated trainer and am here to help you meet and achieve all your fitness goals. This intake form is the first step of your personalized fitness plan.

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Contact Information

Medical History

Have you ever been involved in a car accident that’s caused back injury or other type of injury?

Fitness Profile

Have you ever trained in a gym or with a fitness trainer before?
What are your fitness goals? (Choose all that apply)
Are you currently dieting?
Do you prepare your own meals?
Are you married?
Do you have children?
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