Rebel Personal Training — New Client Intake
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Personal Training
REBEL
Training Ltd.
New Client
Intake Form
2026
/// NEW CLIENT ///
01 — Personal Info
First Name
Last Name
Email Address
Phone Number
Age
02 — Your Goals
Primary Goal — What are you training for?
Fat Loss
Build Muscle
Get Stronger
Athletic Performance
Toning & Definition
Endurance
Mobility & Flexibility
Accountability
Describe your goal in your own words
Timeline — When do you want to see results?
1–3 Months
3–6 Months
6–12 Months
Long Term
03 — Training Background
Experience Level
— Select —
Complete Beginner
Some Experience (< 1 year)
Intermediate (1–3 years)
Advanced (3+ years)
Current Training Frequency
— Select —
Not training currently
1–2x per week
3–4x per week
5+ times per week
Motivation Level — How committed are you right now?
Low
High
7
Previous training experience — what have you tried?
04 — Health & Lifestyle
Any injuries, medical conditions, or physical limitations we should know about?
Average Sleep Per Night
— Select —
Less than 5 hours
5–6 hours
6–7 hours
7–8 hours
8+ hours
Stress Level (1–10)
5
Nutrition — How would you describe your current eating habits?
Needs Work
Average
Pretty Good
Dialed In
05 — Logistics
Preferred Sessions Per Week
— Select —
1x per week
2x per week
3x per week
4+ per week
Online / Remote only
Training Format
— Select —
In-person 1-on-1
Online / Remote Coaching
Hybrid (both)
Best Times to Train
— Select —
Early Morning (5–8am)
Morning (8–11am)
Midday (11am–2pm)
Afternoon (2–5pm)
Evening (5–8pm)
Flexible
How did you find Rebel?
— Select —
Instagram
TikTok
Friend / Referral
Google Search
Word of Mouth
Other
Anything else you want us to know before we connect?
Submit Inquiry →
We'll review your form
and reach out within 24 hours.