PERSONAL TRAINING
SPECIALIST (PTS)
Consultation Booklet
Name:
Pronouns:
Date of Birth:
Phone/Text:
Email:
Preferred Method of Communication:
Emergency Contact (Name & Phone):
Text Message
Email
Phone
Know Your Client
1. What prompted you to contact me about personal training?
2. What do you hope to get out of our time together? What can we focus on specifically for you?
PAR-Q+
YES NO
1. Has your doctor ever said that you have a heart condition OR high blood pressure?
2. Do you feel pain in your chest at rest, during your daily activities of living, OR when you do physical
activity?
3. Do you lose balance because of dizziness OR have you lost consciousness in the last 12 months?
4. Have you ever been diagnosed with another chronic medical condition (other than heart disease or
high blood pressure)? If yes, list:
5. Are you currently taking prescribed medications for a chronic medical condition?
If yes, list condition(s) and medications:
6. Do you currently have (or have had within the past 12 months) a bone, joint, or soft tissue (muscle,
ligament, or tendon) problem that could be made worse by becoming more physically active? Answer NO
if you had a problem in the past, but it does not limit your current ability to be physically active.
If yes, list:
7. Has your doctor ever said that you should only do medically supervised physical activity?
If the client answered NO to all of the questions above, they are cleared for physical activity. If they answered YES, they must complete
the PAR-Q+ Follow Up Questions (see http://eparmedx.com/).
HEALTH HISTORY QUESTIONS
YES NO
1.
Have you had surgery in the last two (2) years? If yes, list:
2.
Are you, or have you been, pregnant? If yes, when:
3.
Do you take any medications on a regular basis? If yes, list:
4.
Do you have experience or family history with any of the following conditions?
⃝ Arthritis ⃝ Heart Disease ⃝ Stroke ⃝ High Blood Pressure ⃝ Low Blood Pressure ⃝ High Cholesterol ⃝
Cancer ⃝ Asthma ⃝ Fibromyalgia ⃝ Depression ⃝ Disordered Eating ⃝ Diabetes ⃝ Mental Health Concerns ⃝
Stress
⃝ Sleep
5.
Issues
Other (list):
Do you have pain, stiffness, or poor mobility in any joints? If yes, list where:
Waiver: I acknowledge my consent to participate in any physical activity involved in the consultation session. I understand that the
Personal Training Specialist has the right to stop me from doing exercise which they feel would be harmful to me or to stop me from
exercising should they observe symptoms of distress or abnormal response. I understand that there is inherent risk associated with
physical activity such as but not limited to: feeling lightheaded, fainting, abnormal blood pressure, and musculoskeletal injuries, and I
assume wilfully those risks. I will inform the Personal Training Specialist of any unusual pain, discomfort, fatigue, or other symptoms
that I may suffer during or immediately after physical activity. I have read, understood, and completed the PAR-Q+ Form. I hereby
release the Personal Training Specialist and this facility from any liability with respect to damage or injury (including death) that I may
suffer during the consultation session.
Date:
Client Signature:
Witness Signature:
Know Your Client
UNDERSTANDING GOALS (MOTIVATIONAL INTERVIEWING):
What is your top priority health or fitness goal right now?
What does success look like? Feel like? What will you hear others saying when you achieve your goal? How will
you explain your goal achievement to family or friends?
When we get there how will your life change? What will you be doing differently?
What is your timeline for achieving this goal?
Have you tried in the past to achieve this or another health goal? How did that go?
Why is this important to you?
On a scale of 1-10, how confident are you that you can achieve and maintain this goal by yourself?
How do you envision us working together? What can I do to make your goal a reality?
Know Your Client
LIFESTYLE CHANGE QUESTIONNAIRE:
Select 4-6 habits you’d like to shift in the next year.
Rank on a 1-10 scale based on ease of implementation (1 meaning very easy vs. 10 meaning very challenging).
Eating Behaviour:
Implementation Ranking (1-10):
Increase fruit/vegetable servings •
Choose nutrient dense foods more often
Assess and respond to hunger/fullness cues
Avoid distracted eating
Develop a daily eating timeframe
Increase water intake
Other: _______________________________________
Stress Management:
Implementation Ranking (1-10):
Incorporate meditation into each day
Use breathwork to deal with challenging emotions
Express gratitude daily (journal, app, tell someone)
Book a monthly massage
Establish one “screen free” day a week
Plan for the week/day to avoid rushing
Other: _______________________________________
Sleep / Recovery:
Avoid or limit caffeine in the afternoon/evening
Establish a bedtime routine
Avoid or limit screen time 1 hour prior to sleep
Set bedtime and wake-up hours
Enjoy an epsom salts bath on workout days
Do light yoga or mobility work before bed
Other: _______________________________________
Implementation Ranking (1-10):
Know Your Client
GOAL SETTING:
Specific: ____________________________________________________________________________________________________
Measurable: _________________________________________________________________________________________________
Attainable: __________________________________________________________________________________________________
Realistic: ____________________________________________________________________________________________________
Timely: _____________________________________________________________________________________________________
Open: How many times can I _________________________________________________________ this week?
Assess – Feedback – Coach
Choose the best 2-3 passive assessment for your clients.
Blood Pressure:
Resting Heart Rate:
HR Recovery:
Ankles
/ Feet:
Knees:
2
1
Posture Assessment: Consider the client’s goal as you indicate their opportunities on diagrams. It can be
helpful to take photos of the client in 3 positions at hip height (with permission / on their device).
Notice if feet are pronated, supinated, or neutral.
Notice if knees are hyperextended (lateral view) + valgus
(knock-kneed) or varus (bowlegged) from anterior view.
Hips / Pelvis:
3
Hips: Look at the crests for asymmetry between the two
sides. Landmark with hands on PSIS or use a dowel across
top of glutes to analyze if one side is lower than other.
Pelvis: Look at angles (tilt) between ASIS and PSIS
Abduction / Adduction: Look for approximately 7.5 cm
between medial border of scapula and spine.
Shoulders:
4
Notes:
Elevation / Depression: Look for excessively depressed or
elevated scapula.
Head /
Chin:
5
Clavicle: Look at angle of clavicle between the lateral (AC
joint) and medial edges (SC joint) for excessive elevation
or depression.
Look at how the chin lines up
with the shoulder – neutral or forward position.
Goal Specific: indicate the best 2-3 assessments that will provide meaningful information related to the
client’s goals
Body Composition –
Quality of Life –
Performance –
Assess – Feedback – Coach
MOVEMENT QUALITY & ACTIVE FLEXIBILITY ASSESSMENTS
1. Select: 2-3 dynamic assessments that relate to the client’s goal. Modify if required to ensure client feels
successful.
2. Ask: How did that feel? How would you rate your performance on scale of 1-10? How would rate your satisfaction?
3. Feedback: Praise what they did well (or tried) on each assessment. Describe opportunities to improve and
the impact on their goal.
4. Educate: Adjust one aspect of the movement, repeat, ask client to rate their performance/satisfaction.
Explain impact on their goal.
Notes
Notes
WALL
SLIDE
Opportunity
Elbows lose contact
Hands lose contact
Elbows and hands lose contact
Opportunity
Anterior pelvic tilt
Winging scapula
Hips rising
Hips dropping
Shoulders rising
Notes
SQUAT
Opportunity
Forward lean
Feet turn out
Knees caving in
Pelvis falls into posterior tilt
Lateral shift in the hips
Supination occurs at either ankle
PLANK TORSION CONTROL
Primary Assessments
Assess – Feedback – Coach
MOVEMENT QUALITY & ACTIVE FLEXIBILITY ASSESSMENTS
Notes
Opportunity
One side is significantly more mobile
Lower hand does not reach up
Upper hand does not reach down
Notes
STRAIGHT LEG
RAISE
Opportunity
Inability to keep the knees fully extended
as a leg is lifted
Leg externally rotates at the hips as the
hip flexes
Inability to keep the lower back in neutral
as leg is raised
Notes
Opportunity
One or both ankle(s) scores 5 cm or less
One or both ankle(s) scores 10 cm or
more
Difference between each ankle is 5 cm
or more
Notes
SHOULDER
MOBILITY
SPLIT
SQUAT
Opportunity
Slouching through upper back
Knees caving in
Pelvis falls into posterior tilt
Lateral shift in the hips
KNEE TO
WALL
Supplementary or Goal Specific Assessments
Recommendations
Name:
Goal:
Macrocycle
Mesocycle
Why:
Microcycle
Model
Foundations
Block
Evolution
Linear
Mastery
Wave
Full year
Week 1
of
Week 2
training
Week 3
Week 4
Week 5
Week 6
Week 7
Week 8
Week 9
Week 10
Week 11
Week 12
Week 13
Week 14
Week 15
Week 16
Week 17
Week 18
Week 19
Week 20
Week 21
Week 22
Week 23
Week 24
Week 25
Week 26
Description
FITT Resistance
Training &
RPE
FITT
Cardio
& RPE
Lifestyle
Program every
2 months from
easiest to
hardest based on
client’s ranking.
Results & Key
Milestones
Recommendations
Macrocycle
Mesocycle
Microcycle
Model
Foundations
Block
Evolution
Linear
Mastery
Wave
Week 27
Week 28
Week 29
Week 30
Week 31
Week 32
Week 33
Week 34
Week 35
Week 36
Week 37
Week 38
Week 39
Week 40
Week 41
Week 42
Week 43
Week 44
Week 45
Week 46
Week 47
Week 48
Week 49
Week 50
Week 51
Week 52
Description
FITT Resistance
Training &
RPE
FITT
Cardio
& RPE
Lifestyle
Program every
2 months from
easiest to
hardest based on
client’s ranking.
Results & Key
Milestones
Recommendations
SAMPLE WORKOUT – FOUNDATIONS DAY 1:
General Warm-Up (Time and Activity): _______________________________________________________________________
Type of Exercise
Mobility
Stability
Main
Main
Supplemental
Supplemental
Accessory
Accessory
Meaningful
Finish
Grouping
Exercise
Sets
Reps
RIR
Tempo
Rest
Recommendations
SAMPLE WORKOUT – FOUNDATIONS DAY 2:
General Warm-Up (Time and Activity): _______________________________________________________________________
Type of Exercise
Grouping
Exercise
Sets
Reps
RIR
Tempo
Mobility
Stability
Main
Main
Supplemental
Supplemental
Accessory
Accessory
Meaningful
Finish
Follow-Up Action Plan:
Commit to ___ cardiovascular workouts/week
Commit to ___ strength workouts/week
Commit to ___ lifestyle change/month: __________________________________________________
Other next steps: __________________________________________________________________
Reassessment Date: _________________________
Rest
Recommendations
TRAINING OPTIONS:
Essentials
Change Maker
Achieve + Save
6-months
9-months
12-months
@ 3x/week = 78 sessions
@ 3x/week = 117 sessions
@ 3x/week = 156 sessions
$PRICE – Bi-weekly
$PRICE less 5% – Bi-weekly
$PRICE – less 10% Bi-weekly
1 Hour Session
1 Hour Session
1 Hour Session
+ Lifestyle Coaching
+ Lifestyle Coaching
+ Lifestyle Coaching
Habit Transformation
Habit Transformation
Best Value
Recommendations
SECONDARY OPTIONS:
Use if client is still saying ‘no’ after you attempt to overcome objections to 6, 9, or 12-month training options.
Foundations
Group Training
Self-Motivated + Coaching
12 sessions over 6 weeks
6-months Asynchronous
$PRICE – one-time investment
$PRICE – one-time investment
$PRICE – one-time investment
1 Hour Session + Lifestyle
Coaching
1 Hour Group Session
Workouts Provided
3-months
@ 3x/week = 36 sessions
Master Foundational Movements
1 Hour Coaching & Assessment
Monthly
Improve Joint Mobility & Stability
Weekly Accountability Check-Ins
Personal Training Specialist Notes:
Action Plan:
• Book a re-assessment in four weeks for clients who decline all training options.
• Write on Workout page above to provide to prospect.
Sample Script: I understand you want to try to tackle your goal on your own [or don’t have time/budget for PT right now] and I know I can still support
you! Take the workout I created and use it over the next month. Let’s book you in after four weeks to re-assess your [insert assessments i.e.. squat,
posture, wall slide, body composition, HR Recovery, etc.] because I want to see your improvements and hold you accountable to your goals.
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