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Your Name

Email Address

Phone Number

Goals (tick all that apply) Goals (tick all that apply) Weight / fat loss Physique transformation Improve health and fitness

Describe the biggest challenges you've faced when trying to achieve your goals in the past

Visualise and then describe what achieving your goals will mean to you and how you will feel when you achieve them

Are you prepared to prioritise every aspect of personal training in your life for the duration of the programme? Are you prepared to prioritise every aspect of personal training in your life for the duration of the programme? Yes No

Are you prepared to invest in yourself to achieve your goals? Are you prepared to invest in yourself to achieve your goals? Yes No