Personal Training Questionnaire
Name
*
First
Last
Phone
*
Format: (000) 000-0000.
Email
*
Age
*
Weight
*
Height
*
Gender
*
Please Select
Male
Female
Whats the activity level at your job?
*
Please Select
None (seated only)
Moderate (light activity such as walking)
High (heavy labor, very active)
What is your fitness level?
*
Please Select
Beginner
Intermediate
Advanced
What are your fitness goals? (Check all that apply)
*
Improved health
Improved endurance
Increased strength
Increased muscle mass
Fat loss
If you have any injuries, please list them.
*
Do you have any dietary restrictions?
*
Additional Comments
Submit
Should be Empty: