Holistic Wellness.

Client Consultation Form

Please fill out the form below with as much detail as possible to ensure your fitness journey is tailored to your needs.

Personal Information

Full Name: Email Address: WhatsApp Number With Country Code: Date of Birth: Gender:

PAR-Q Summary

Please confirm if you answered "YES" to any PAR-Q questions (Physical Activity Readiness Questionnaire):

Yes No

If yes, please provide additional details:

Training History

Do you have any training history?

Yes No

Fitness and Lifestyle Details

Current Activity Level: Work Schedule:

Body Measurements

Please provide your body measurements for tracking and analysis. Height (in cm): Weight (in kg): Waist (in cm): Neck (in cm):

Medical History

Do you have any medical conditions? Do you have any past injuries or surgeries?

Nutrition & Dietary Habits

Describe your current diet and foods that you like: Dietary Preference: If "Other," please specify: Do you have any food allergies? Average daily water intake (liters):

Your Goals

Short-term Goals (e.g., 1–3 months): (Weight/Fat Loss) Long-term Goals (e.g., 6+ months): (Muscle Gain, General Health)

I agree to the terms and conditions. Before submitting, please complete the PAR-Q form.