Client Questionnaire (Training Only)

Train With Payne Client Questionnaire

* Indicates required field

Name *

First

Last

Email *

How did you hear about Train With Payne Fitness? *

If referred by a friend, please add their name below. *

Instagram Account Name (If Available) *

Gender *

Age (Years) *

Height (Feet & Inches) *

Weight (Lbs) *

Body Type *

What is your goal? (Be as specific as possible) *

What is your time frame to reach your goal? (Be as specific as possible) *

What is your current level of fitness? *

How many days per week do you workout? *

When do you usually workout? *

Do you have any injuries or limitations that will prevent you from, or complicate you being able to physically train? *

If you answered YES to the above question, please explain below. Be as descriptive as possible. *

Are you taking any perscription medications? *

If you answered YES to the above question, please list your medications below. *

Legal Disclaimer
The content provided in this work offers health, fitness and nutritional information that are designed for educational purposes only. This content is by no way intended for use as medical advice or as a substitute for medical counseling. Nothing stated in this work is intended to be, and must not be taken to be, the practice of medicine and counseling. No warranty of any kind, implied or express, is made as to accuracy, completeness, appropriateness or effectiveness of content provided herein. Seek professional medical advice prior to participating in or practicing any exercise, movement, or nutritional program disclosed, suggested, or referred to herein. You should not rely on this information as a substitute for, nor does it replace, professional medical advise, diagnosis, or treatment. Do not disregard, avoid, or delay obtaining medical or health related advise from your health-care professional because of something you may have read in this work.
The use of any information provided in this work is solely at your own risk.
By moving forward with any program or in accordance with this communication, you waive any claims against any entity involved with or related to this communication and agree that no such entity is responsible or liable to you or anyone else for any loss or injury or any indirect, incidental, consequential, special, exemplary, punitive or other damages under any contract, negligence, liability or other theory arising out of or relating in any way to (i) the use or inability to use this work or the product, services, or techniques disclosed herein; (ii) any content contained in this work and or product and or service disclosed herein; (iii) any content contained in this work; (iv) any action taken in response to or as a result of any information available in this work. In no event shall any liability owed to you for any and all damages, losses, and causes of action (whether in contract, tort, statutory or otherwise) exceed the amount paid by you, if any, for using or accessing this work.
You agree to indemnify, defend, and hold any entity involved with this communication as well as their subsidiaries, affiliates, officers, directors, agents, co-branders or other partners, employees, and representatives harmless from and against any and all claims, damages, losses, costs or expenses (including reasonable attorneys' fees and disbursements) which arise directly or indirectly out of or from your use of content provided herein.

Submit

Train With Payne Client Questionnaire

Services

Company