Smittybeliftin Inquiry Form

Name

Email

Phone Number

Preferred contact number

Preferred Pronouns/Gender

Rather than assume your gender, let me know how to address you respectfully (if comfortable)!

Current Activity Level

Completely/Very Inactive

Slightly Active

Moderately Active

Very Active

Think about how often & consistently you exercise/move your body throughout a typical week

My work involves a lot of...

sitting

standing

walking/moving/bending

driving

I'm interested in... (check all that apply)

In-Person Sessions (1-on-1 training in a gym or home setting)

Virtual Sessions (training via video streaming such as Apple FaceTime or Google Duo)

Smitty System Programs (guides designed how Smitty trains alone, but adaptable for all levels)

Personalized Training Program (guide for solo training, designed on client goals, abilities, etc.)

For additional information on the various services offered

Desired availability/timing (if interested in training sessions)

List the days & times you'd like to train & know you can consistently maintain; sessions available Monday-Saturday

I have access to... (check all that apply)

Gym membership/training facility

Home training equipment

Park/Playground (or other outdoor space)

None of the above

If any gym memberships, which chain(s)?

This will help w/ planning for sessions or programs

If you have any home equipment, what do you have?

List any weights, machines, or other equipment you own for any home training

Do you have any aches, ailments or pains that affect your activity level?

Any nagging pains, past surgeries or health matters that can impact training, list them here!

What are your main goals?

Provide any details on the goals you plan on working toward & desire from your training

3 Good Words

Whateeeeever comes to mind