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Name
First Last
Date of birth
Email
Occupation
Mobile number
Height
Weight
Emergency contact name & mobile
How did you hear of the Dan Roberts Group*
- A personal recommendation
- TV / Radio / Newspaper feature
- Public Event or Talk
- Google
- Instagram(@teamdanroberts)
- Twitter (@teamdanroberts)
- Linkedin (@DanRobertsPT)
- Via the Methodology X™ brand
- Via the Nuk SOO™ brand
- Other
What injuries do you have?
Do you have (or have a history of) any of the following?
- Epilipsy
- High blood pressure
- Low blood pressure
- Diabetes
- Disordered eating
- BDD
- ADHD
- Panic Attacks / Anxiety
- Raised cholesterol
- Liver or Kidney conditions
- Digestive problems
- Any heart condition
- Epilepsy
- Hernia
- Osteoporosis
- Arthritis
- Asthma
- Cramps
- Muscular pains
Do you smoke?
- No
- Occasionally
- 40+ a week
How much do you drink?
- Occasionally
- 10+ units most weeks
- 25+ units most weeks
What medications are you on?
Do you have any infectious diseases?
- No
- Yes
Have you been recently hospitalized?
- No
- Yes
Have you recently had surgery?
- No
- Yes
Are you pregnant?
- No
- Yes
Do you accept our Policies.*
- Yes
Please see link in Footer menu for our data policy and all other standard DRG policies. For insurance purposes, we can only help you if you accept these.
Waiver of Liability: Please read*
All physical training has inherent risks. To the extent permitted by law, we accept no liability for persons injured following our exercise, nutrition, well-being or any other advice. For the avoidance of doubt, clients also waive all liability that we may have for any accidents or injury, except as a direct consequence of our negligence, occurring as a result of any martial arts, screen contact and/or combat training If any medical or other conditions arise that could affect your training with us, you shall let us know immediately by email. If you have any doubts, please consult your doctor prior to physical activity. All exercise, nutrition, well-being or other advice given to you by any persons associated with Dan Roberts Training Ltd & Dan Roberts Enterprises Ltd is taken entirely at your own risk.
Please read and sign above
Did you read and fully accept the liability waiver above?*
- Yes
- No (Sorry. For insurance reasons we will not be able to help you)
Which of your goals can we help you with?
What triggered you to contact us now, why not last month?
What other fitness and wellbeing goals do you have?
Why are these goals important to you?
What training do you currently do?
If you would like us to contact your last trainer, please give details.
What are your expectations?
Which exercises/activities do you love doing and why?
Do you want help with nutrition?
- No thank you
- Maybe
- Definitely
Do you want help with stress?
- No thank you
- Maybe
- Definitely
Do you want help with body image?
- No thank you
- Maybe
- Definitely
Which activities interest you?
- Weight Lifting
- Olympic lifting
- TRX
- Body weight movements
- Cross Fit
- Ballet / Dance
- Boxing
- MMA / Martial Arts
- Stunts & Fight Choreography & Weapons
- Yoga
- Pilates
- Meditation
- FST & Mobility
- Sprinting
- Long distance running or cycling
- Competetive Sports
- Speed, Agility & Reaction Training
Have you worked with Trainers before? (What worked and what didn't?)
Is there anything else you would like to share?
Do you know what coach you want?
- Dan Roberts: (£200 ph)
- Senior Coach/Specialist
- Yes, a specific mix of coaches
- I don't mind. Up to you!
How often do you want to train with us?
- I want a very intensive programme
- 5 x per week
- 4 x per week
- 3 x per week
- I don't know / up to you
Are you interested in any of our specialist services?
- Regular Personal Training
- Strength & Conditioning for Pro Athletes
- Movie Role Preparation
- Fashion Model Conditioning
- Executive Training
- 100 Day Plan
- Miami Retreats
- Swiss Alps Retreat
- International: We travel to you
- Bespoke Online Coaching: (starting at £1500 pm)
- 1-2-1 Virtual PT Sessions
- NUK SOO™ / Methodology X™
Where are your preferred coaching locations
- Ham Yard Hotel, Piccadilly
- The Kensington Studio, High Street Kensington
- Your London Home
- Shangri-La Hotel, At The Shard (GUESTS ONLY)
- Four Seasons Grosvenor Square (RESIDENTS ONLY)
- The Athletics Track, Battersea Park
- Online
- Other
What is your availability to train?
When would you like to have your face-to-face consultation with Dan?
These are usually held at the Ham Yard Hotel in Soho. Telephone/ Zoom consultations are also available.
Do you have any specific additional questions for Dan?

Your Privacy

Your information is sent in the strictest confidence directly to Dan Roberts. We require all potential clients for any of our coaching services (online, London 1-2-1 and international retreats) to fill out this form. Dan will get in touch within 72 hours of submission.

Our Personal Training Fees:

Dan £200 per session
Specialist Trainers – Starting from £125 per hour

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"A man that makes Oscar-winners and royalty sweat, his forensic knowledge of all things fitness is jaw-dropping."

“One of the most respected and talked about fitness and wellbeing companies in the UK.”

“The Dan Roberts Group is a luxury brand to watch.”

“The go-to PT for several Royal families and Hollywood film studios.”

“Personal Trainer to the stars.”

“Dan Roberts is the greatest celebrity trainer.”

“Dan is PT to a slew of Victoria Secret Angels and the man A-list actresses call when they come to London.”

"Britains leading Personal Trainer, Dan Roberts is one of the most important figures in the wellbeing industry.”

“World-renowned trainer Dan Roberts is the man behind some of the worlds hottest bodies”

“Dan is one of Europe’s leading strength & conditioning coaches.”

The Dan Roberts Group has been a winner at the 2015, 2017 & 2019 Tatler Annual Gym Awards

"Dan Roberts, aka the Model Sculptor is the first choice for supermodels"

"Dan Roberts' clients are an international who’s who from the worlds of acting, fashion, music and sport."