Book 30 minute consultation here

By filling in this short form and submitting it, we will have some basic information to enable us to have a useful discussion about what you need and how we can potentially help. There is no obligation to buy and we hope the consultation as a stand alone offer is useful.

All information is stored in line with GDPR sensitive data laws.

1 CONTACT AND BASIC BACKGROUND

First Name

Last Name

Date of Birth

Mobile Phone

Health and Fitness Goals

2 ESSENTIAL HEALTH SCREEN/PAR-Q

Please fill out the following form, to help assess whether before commencing physical activity you should check with your doctor in order to participate in our activity.

Have you been told you have a heart conditon?

Are you suffering from a medical condition, illness, or injury?

If you answered yes to any of the two questions above, please elaborate. If No, please continue to fill out this form.

How would you describe your occupation and usual working patterns?

3 OPTIONAL ADDITIONAL INFO

Please fill out the following form, to help assess whether before commencing physical activity you should check with your doctor in order to participate in our activity.

How would you describe your current eating patterns; a typical day?

How many hours of sleep do you get most nights?

What exercise do you currently do and how often? Also any exercise you enjoyed but do not currently take part in.

Outline your main reasons for wanting to improve your levels of Fitness, this is really important information for developing the right plan to achieve your aspirations and goals.

Any conditions or recent injuries that affect your ability to exercise.

I agree to the terms & conditions of business. View terms of views.View terms of business

I declare that the info I've provided is accurate & complete.

I have read and agree with the Privacy notice in relation to my engagement with Kate Brooks Fitness. GDPR information.View GDPR document

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