Fitness Consultation

1

Full Name* This field is required.

First Name

Last Name

2

Gender

Male

Female

Other

3

Phone number* This field is required.

4

Email* This field is required.

5

Occupation

6

What is the activity level at your job?

none(seated only)

Moderate (light activity such as walking)

High (heavy labor, very active)

Other

7

Recreational activities (sports, events):

8

Physically/mentally strenuous hobbies (if any)

9

Have you ever exercised before?

Yes

No

10

If so, when was the last time you exercised?

11

Have you trained with a personal trainer before?

Yes

No

13

Anything else you want to add that you think will help