2. Client Profile
Please assist me by filling out this brief questionnaire
Your Full Name:
Phone Number:
Email:
Home Address:
Gender:
Age:
Occupation and Workplace Location:
How did you first discover Killit Fitness?
3. Client Profile
What are you currently doing for exercise? (Please include frequency)
Have you trained with a personal trainer before, or on a coached sports team? (If yes, please explain)
Do you have a gym membership somewhere? (If yes, how much do you pay for a monthly membership)?
Do you prefer to train outdoors, in your home, a fitness facility, a combination of the above, or other?
How many days per week do you wish to train?
What do you hope I can help you achieve?
What dollar value per month do you place on your health and physical appearance? (Personal training, gym
membership, nutritional plan and lifestyle guidance) :
($50-$100)
($100-$150)
($250-$350)
($400-$600)
4. Client Profile
Please list your fitness goals in the categories that apply to your needs:
•Weight/Size :
•Physical Fitness Abilities :
•Internal Health & Bodily Functions :
•Nutritional :
•Events/Challenges/Sports-Related :
Do you have any Injuries or health issues that could affect your ability to exercise or maintain a diet?
Are you currently on any medications?
Do you smoke cigarettes or have quit smoking in the past 6 months?
Do you wish to train with a friend or alone? (Sessions can be administered with up to 3 people, and discounts will
apply)!
5. Your Weekly Schedule
Please indicate with a star (*) the days and times you can potentially set aside for some form of exercise, whether it be training
with a personal trainer, or doing something on your own. Please fill in the times in the left hand column as well. You may also write
in any other daily commitments (such as work/school), to give me a better idea of how we can plan a healthier lifestyle for you).
Time of Mon Tues Wed Thurs Fri Sat Sun
Day
Example 7am- * * * * * *
8am
Example 9am- Work(mon-fri)
5pm
Example * * * * * *
6:30pm-10pm
6. Killer Packages
Killer Bod
-Consultation
-Goal setting
-Monthly Measurements
-Before & After Photos
Lean & Mean -Movement Screening
-Exercise Program Design
-Consultation -2 to 3 Personal Training Sessions per week*(includes
-Goal Setting assisted workouts, stretches,
-Monthly Measurements post-workout massage and roller)
-Before & After Photos -Nutritional Analysis
-Movement Screening -Dietary Needs Consultation
-Exercise Program Design -Eating Plan by a Registered Dietician*
-2 to 3 Personal Training -Healthy Lifestyle Support
Killer Kick-Starter Sessions per week*
(includes assisted workouts, stretches, *3 sessions = added $40 charge per week
post-workout massage and roller) *1-Month Eating Plan
-Consultation
-Goal Setting -Healthy lifestyle support
-Movement Screening
-Exercise Program Design *3 sessions = added $40 charge per week $600 / month
-First Session (includes how-
to, demos, explanations, form $320 / month
correction, tips and tricks)
-healthy lifestyle support
$150 flat rate
