Quick intake · under 5 min

Gold — Coached

£147 · one-off payment

A few quick details + a 3-question health screen so I can tailor your programme. You'll go straight to secure Stripe checkout once you submit.

1. About you

Full name *

Email *Phone *

Date of birth *Sex *

Height (cm) *Weight (kg) *

2. Your training

Primary goal *

Experience level *Sessions / week *

Gym access *Anything else about your goals, schedule or equipment? (optional)

3. Health screen

Answer truthfully — if anything is "Yes", I'll get in touch before starting.

Has a doctor ever told you to only do physical activity under medical supervision (heart, blood pressure, dizziness, chest pain, etc.)?

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Do you have any injuries, joint problems, or conditions (including pregnancy) I should know about before programming for you?

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Are you on any medication that affects exercise (e.g. for blood pressure or a heart condition)?

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4. Consent

The info above is accurate and I consent to Personal Trainer Hackney storing it to design my programme. I'll consult my doctor if I answered "Yes" to anything in the health screen.Type your full name as your signature *

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