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Get fit in 20 minutes with EMS training

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Welcome to FITTECH Boutique!

Few things to do before your first

EMS session

Consultation Form

Thank you for choosing FITTECH Boutique! Please fill up this consultation form.

This will help us better understand your fitness requirements and will ensure a great and safe experience during your EMS training.

All your responses will only be used for internal purposes to serve you better and will never be shared with 3rd parties.

Who Are We

Section 1. Essential Contact Information

First Name

Last Name

Email

Phone

Your address

Emergency Phone number

Date of Birth

Nationality

Marital Status

Occupation

How to find you on Instagram?

Branch

Promo Code

How did yo hear about us?

Google search

Social Media

Flyers & Print-outs

Partner Promo

Walk-in

Family & Friends

Member Referral

Name of the Partner

Section 2. Your Lifestyle and Goals

Goals

Lose weight

Reduce body fat

Toning and firming

Increase muscle mass and strength

Improve energy and stamina

Reduce back pain

How much weight do you want to lose?

How much muscle mass do you want to gain?

Which describes you best?

I am a self-motivated person

I find exercising easier with a partner

I find exercising easier with a schedule/ regular appointments

I need constant motivation to stay on track

Usually I experience some problems to stay motivated

I am inconsistent with my exercise

Who is supportive of you achieving yor fitness goals?

Family

Friends

Colleagues

Partner

Only myself

What are your expectations from the EMS training and your personal trainer?

How important is achieving these goals to you?Not important at allBarely importantSomewhat importantVery ImprotantExtremely importantHow important is achieving these goals to you?

What is the expected timeline to achieve your goals?

If you currently exercise, what activities are you doing?

Section 3. Health Declaration

If female, are you currently pregnant / suspected to be pregnant?

Do you have any metal implants?

Are you under any medications / supplements?

Do you have a pacemaker installed?

Do you smoke?

Do you suffer from any past/present injuries?

Please provide details on your injuries (if any) or anothing else we need to know before we start the session?

Section 4. Physical Profile

Height

Weight

Select your current state of body

Section 5. Agreement

I hereby agree that all information provided above is accurate and correct. I am fully aware of the risks and will not hold the brand responsible/ liable nor will I pursue any legal/ personal compensation for any injury, illness or death of any member occurring during or after a session, whether caused by the equipment (faulty or not), incorrect operation or any other occurrence. I accept has the full responsibility to keep the trainer informed of any discomfort or pain, so that precautions can be taken.

I agree with the above statement and accept terms & conditions

I want to subscribe to the newsletter.

I agree to use photo/video recording to track my progress

I agree to use photo/video recording to share my results with others

Your Signature

Thanks for submitting! Have a great EMS session!

Smart EMS training in Singapore

Our locations:

Katong branch: 188-5 Tanjong Katong Rd, Singapore, 436990

Clarke Quay branch: 23 New Bridge Rd. L4, Singapore, 059389

hello@fittech.sg

WhatsApp / Call: +65 8654 0195

©2022 FITTECH Boutique Singapore

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