The Basics
Name *
Date of Birth *
Date of Birth
Your Address *
Your Address
Primary Phone Number *
Primary Phone Number
Preferred method of communication
Emergency Contact Name *
Emergency Contact Name
Emergency Contact Phone Number *
Emergency Contact Phone Number
Health History
Example: Dislocated shoulder (left) - 2016, knee surgery (right) 2017, pain in hip (right) when running - current
Example: Beta blockers, fish oil, CBD
Coffee, green tea, energy drinks, etc.
Take work/money/relationships/body image/health/family all into consideration.
Feel free to list more or less if necessary.
Body Image
Example: Keto, vegan, Weight Watchers, etc.
Example: Vegetarian for 3 years, Jenny Craig for 1 year, etc.
Examples: Cook more at home, improve my body confidence, start a family, find a new job, sleep better, relax more, travel, etc. It's ok if you have more or less than 3, or don't know right now.
Examples: Increase deadlift, 10 push ups, run a marathon, learn more about how to make my own workout, reduce pain in knees, etc. It's ok if you have more or less than 3, or don't know right now.
Fitness Habits
Examples: Strength training 3x per week, walking the dog daily, Soul Cycle 1x per week, biking to work daily, etc.
Policies + Rates
Please initial that you have read and understood the cancellation, attendance, Access Pass policies and rates.
Advanced notification must be given for ALL cancelled workouts. Clients will be responsible for full payments on any workout sessions without 24 hours advance notice if we are unable to fill the training spot with another client or reschedule your session to another time/day.
All clients that hold a weekly reserved session(s) must maintain a 75% attendance record in order to continue holding the spot on a normal basis.
In order to train at DIAKADI, San Francisco's leading personal training facility, all clients must purchase a DIAKADI Access Pass through DIAKADI. Training = $37/month I Training + Gym use without trainer = $65/month I Training + Gym Use + Laundry Service = $100/month The DIAKADI Access Pass gives you access to their complete set of amenities including complimentary client parking, full-service locker rooms, front desk staff, complimentary beverage bar and a 14,000 sq. ft. arsenal of strength training equipment.
8 session package training 2x per week: $1,040 ($130 per session) 16 session package training 2x per week: $1920 ($120 per session) Personal Training and Body Love Blueprint Hybrid Program: +$450 to any of the packages above
Today's Date *
Today's Date