Pvolve Nashville Personal Training Questionnaire

Personal Training Questionnaire

Please complete before our first scheduled session.
Name

First NameLast Name
MaleFemaleOtherPrefer not to say
Date of Birth

MonthDayYear
Date
Age (Optional)
Height
Weight (Optional)
What do you do for a living?
None (seated only)Moderate (light activity such as walking)High (heavy labor, very active)
What is your current fitness routine?
1-2 times per week3-4 times per week5-6 times per weekEveryday
Early MorningMid MorningLunch timeAfternoonEveningI am flexible
In the Pvolve studioVirtuallyIn my own home/workout spaceI would prefer a mix of both
Do you have any diagnosed health concerns? If so, please list.
Do you have any injuries or limitations? If so, please list.
Are you engaged in any form of exercise or physical therapy for these concerns/injuries? If yes, please explain.
Do you suffer from diabetes, asthma, vertigo, high or low blood pressure?
Improved mobility and flexibilityImproved enduranceIncreased strengthIncreased muscle massFat lossPre/post natalOther
Please list any other goals you are looking to achieve from our PT sessions:
No small talk - I want to work hard and stay focusedI like to keep it light and conversational - this should be fun!I want to have input into what we are working on during our sessionI like when a trainer asks how I am feeling and tailors the intensity of the workout accordinglyWith fun music to keep the energy highNo music - I like to focus on the workout itself with no distractions
What are your overall expectations of me as your Personal Trainer?

What is your timeline for achieving your goal?

Rows	8 WKS	16 WKS	24 WKS	32WKS	40KS	1 YEAR
Now

Please rate your motivational level to do what it takes to reach your goal.

1

2

3

4

5

1 is Worst, 5 is Best
Please list anything else I should know before our PT sessions
1.) CANCELLATIONS

Cancellations must be made at least 12 hours in advance of a scheduled session. The client is responsible for notifying the Trainer of their request to cancel. If a client fails to cancel, 12 hours in advance, he/she may forfeit a package session. If the client has already used their package session, or if he/she is a drop-in user (i.e not a package holder), his/her credit card may be charged. Early cancellations (more than 12 hours in advance of class session starting time) have no penalty fees.

2.) LATE ARRIVALS / INTERRUPTIONS

Each session shall be 50 minutes in length. Sessions will not be extended 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.
YESNO
Should be Empty: