The main office for Complete Body is based in
New York City. However, we do have a team of personal trainers available around the world and abroad. Please take 3 minutes to fill out the following questionnaire. All client information
is strictly confidential and never shared with
anyone else.
Name
E-Mail Address
Street Address
City
Country
State or Province
 Postal Code
Home Phone Number (country code included, please)
Business Phone Number
 Fax
Personal Information
Date of Birth
 Age
Sex
Height
 Weight
Weight 1 year ago
 Weight at 21 years of age
3. Occupation:
Medical Information

Do you have any physical or medical condition that would limit you from engaging in a safe exercise program? Include any surgery you may have had .

If you answered yes in the question above, please explain in detail how your condition affects your athletic ability

List any medications you are currently taking:
Availability for Workout
How many times per week do you plan to train with us?

Please indicate the times and days you are available to train:
Please provide a day and time which would be convenient for you to schedule your initial Fitness Evaluation:
Alternative Day and Time:
What are your 3 main fitness goals?
Please indicate what you are looking for in a personal trainer?
Services Offered
Check any of the services/activites that interest you:
Outdoor Workout
Sports Conditioning
Physical Therapy
Pre-Post Natal Therapy
Nutritional Counseling
Kick Boxing
Horseback Riding
Body-Building
Trainers Available for Travel		 Acupuncture
Boxing
Golf
Dance
Massage
Yoga
Fencing
Water Sports
Meal Delivery
Other:

Where did you hear about Complete Body?