Personal Training Questionnaire
  • Gender
  • Whats the activity level at your job?
  • How often do you travel?
  • Are you experiencing any stresses or motivational problems?
  • Has anyone of your immediate family developed heart disease before the age of 60?
  • Do any diseases run in your family?
  • Do you suffer from diabetes, asthma, high or low blood pressure?
  • Are you a current cigarette smoker?
  • Your current diet could be best characterized as:
  • Please rate your readiness for change.
  • What following goals does best fit in with your goals?

  • Rows
  • Are you currently excersising regulary (at least 3x per week)?
  • Have you trained with a personal trainer before?
  • At what times during the day would you prefer to train?
  • In Person Training Package Options
  • Remote Training Package Options

  • 1.) CANCELLATIONS Cancellations should be made at least 24 hours in advance of a scheduled session. Sessions cancelled less than 24 hours in advance will be charged in full to the client. 2.) LATE ARRIVALS Each session shall be 1 hour in length. Sessions will not be extended (unless time is available) due to the lateness of the client or due to interruptions caused by the client. 3.) ALL THE INFORMATION I HAVE GIVEN IS CORRECT All the information on this form is correct and to the best of my knowledge. I have sought and followed any necessary medical advice. I understand that all the information given will be kept confidential.

  • I AGREE TO THE ABOVE TERMS & CONDITIONS!*
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  • I hereby affirm that I am voluntarily starting a course of instruction in physical fitness and performance training (The Activity). I am voluntarily participating in the Activity entirely at my own risk.

    In full consideration of the risk of injury while participating in the Activity, and for the right to participate in the Activity, I hereby, for myself, my heirs, executors, administrators, assigns, or personal representatives, knowingly and voluntarily participate in this waiver and release of liability and hereby waive any and all rights, claims or causes of action of any kind whatsoever arising out of my participation in the Activity, their affiliates, managers, members, agents, attorneys, staff, volunteers, heirs, representatives, predecessors, successors and assigns, for any kind of risks related to traveling to and from as well as participating the Activity, which may include, but are not limited to, physical or phycological injury, pain, suffering, illness disfigurement, temporary or permanent disability, economic or emotional loss, and death.

    I acknowledge that I have carefully read this form and fully understand that it is a release of liability. I expressly agree to release and discharge the trainer or instructor from any and all claims or causes of action and I agree to voluntarily give up or waive any right that I may otherwise have to bring a legal action for personal injury or property damage.

  • Date
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  • Should be Empty: