Sign Up

Thank you for deciding to use our service.

You are one step closer to improving your overall fitness and health goals. The sign up process forms part of the consult as we ask a lot of personal questions to be able to assist you better in the future with your health and fitness.

The information that you provide in the sign up process is very important, once we have received your information, we may contact you to discuss any information you have provided before we can sort and discuss your first session.

As part of this sign-up process, it is very important that you read through our terms and conditions so that you understand the client/trainer relationship.

This will also act as your acceptance to be trained by MD Fitness.

Most of all, have fun with your journey.

Your Name

Date of Birth

Gender

Female Male

Mobile Number

Phone Number (Evenings)

Address

Town/City

Post Code

Occupation

Emergency Contact Name

Emergency Contact Number

Family History

This section will provide important information that will help when prescribing and designing a fitness plan that suits you. Family history only gives us an indication of what type of things we may help to prevent in the future

Personal and/or family illnesses

Please explain further about any conditions you or a close family member has suffered with

Smoking - Do you smoke?

Yes No

Smoking - Have you ever smoked?

Yes No

Smoking - how many per day?

Smoking - When did you quit?

Are you taking any Medication

Yes No

Medication - if yes, please describe?

Do any of the above injuries have an impact on your ability to exercise, if so please explain further?

Is there anything else that may affect you exercising to your full potential?

Blood Pressure (BP)

Normal Range is between 110/70-120/80

Do you know your BP?

Yes No

If Yes, what is your BP

Physical Profile

This information will help MD Fitness design the best plan for you.

Weight

Height

Clothing Size

Goals

We will work together to reach your goals!

Your Personal Goal Statement

What is this? These are your own words which will hold you accountable to yourself. Your trainer may use the statement you provide to remind you of the reason you started your journey. Example: I am getting married, I want to look my best on my wedding day - push me hard!

What is your personal Goal Statement?

Target Goal Weight

Goal Clothing Size

Your commitment - how important is it to you that you achieve the goals above?

Motivation - which phrase best describes your motivation levels?

I am self-motivated I find exercise easier to stick to if I have a partner I find exercise easier with regular appointments I usually experience some problems staying motivated I need constant motivation to stay on track

Support - who are your support crew? The people that are making sure you are reaching your goals?

Family Friends Work Colleagues The PT

What are you expecting from MD Fitness Personal Trainer?

How many days are you planning to train per week?

Two rest days are advisable, however, this will be dependant on your goals. We recommend passive active on rest days, walking, riding, having fun.

Skip this section if you are signing up to one of our accountability programmes only

Training Other - Please explain?

Your Training Experience (Explain)

Training Time - How Long

30 minutes 60 minutes 90 minutes

Any additional information you want to add about your training?

Package Details

More information can be found in PT Pricing Here

Terms and Conditions

Please make sure that you have read our terms and conditions and accept them by ticking the form. Please note that by sending this form you automatically agree to accept our terms and conditions.

I accept this agreement in the waiver of my signature

I agree and accept that I have read the T&C's and understand them. I am still considering this service and do not currently accept the T&C's at this point.

MD Fitness is passionate about the health and fitness industry. They want to make sure that their clients are succeeding in the gym environment. Book a consult with us today so we can help you throughout your journey.

Family History

Personal and/or family illnesses

Blood Pressure (BP)

Physical Profile

Goals

Your Personal Goal Statement

How many days are you planning to train per week?

Package Details

Terms and Conditions

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