• Personal Training Intake Form

    Personal Training Intake Form

  • Thank you for your interest in personal training with the SJCC! We are excited to work with you on your fitness and wellness goals. 

    Please fill out the form below to begin the intake process. Once we have received your form, we will reach out to you with more details and/or to request more information. 

    If you have any questions, please send an email to fitness@sjcc.org 

  • Format: (000) 000-0000.
  • Are you a current SJCC member?*
  • Birthdate*
     - -
  • I prefer to be paired with a Personal Trainer who identifies as:*
  • Rows
  • How many times per week would you like to meet with a trainer?*
  • What is your desired session length?*
  • Would you be interested in group personal training?
  • If yes, do you have a group already or would you like us to find you a partner to work with?
  • What is your preferred form of communication?*

  • Physical Activity Readiness Questionnaire

    Please read the following questions carefully and answer each honestly.
  • Has your doctor ever said that you have a heart condition or high blood pressure?*
  • Do you feel pain in your chest at rest, during your daily activities, OR when you do physical activity?*
  • Do you lose balance because of dizziness OR have you lost consciousness in the last 12 months? (Please answer NO if your dizziness was associated with over-breathing, including during vigorous exercise.)*
  • Have you ever been diagnosed with another chronic medical condition (other than heart disease or high blood pressure?)*
  • Are you currently taking prescribed medications for a chronic medical condition?*
  • Do you currently have (or have you 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? Please answer NO if you had a problem in the past, but it does not limit your current ability to be physically active.
  • Has your doctor ever said that you should only do medically supervised physical activity?*
  • Have you had any major surgeries that might impact your ability to exercise?*

  • If you answered YES to any of the above questions, someone from SJCC fitness may follow up with you to gather more information. 

  • Should be Empty: