Lamiss Fitness Signup Form
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  • English (US)
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  • Welcome to Lamiss Fitness!

    Thank you for choosing me to be your personal trainer. In order for you to get the most out of our sessions, I need some information about your general state of health, your lifestyle & food choices. I will also ask you to take & upload some pictures so we will be able to track your progress.

  • Personal details

    Tell me about yourself
  •  -
  • Male or Female*

  • Physical Actitivity Readiness Questionnaire (PARQ)

    I need to double check that you are able to follow my workouts
  • Are you currently under a doctor's care?*
  • Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?*
  • Do you feel pain in your chest when you do physical activity?*
  • In the past month, have you had chest pain when you were not doing physical activity?*
  • Do you lose your balance because of dizziness or do you ever lose consciousness?*
  • Do you have a bone or joint problem that could be made worse by a change in your physical activity?*
  • Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition?*
  • Do you know of any other reason why you should not do physical activity?*
  • Do you have any allergies?*

  • Please consult a physician

    If you answered yes to one or more questions, are older than age 40 and have been inactive or are concerned about your health, consult a physician before taking a fitness test or substantially increasing your physical activity. You should ask for a medical clearance along with information about specific exercise limitations you may have.

  • Pregnancy & Childbirth

    A few quick questions about your experience with childbirth & pregnancy
  • When did you last give birth?*
     - -
  • How did you give birth?*
  • Are you currently Pregnant?*
  • Congratulations! When are you due?*
     - -

  • Fitness Related Questions

    Tell me about your current level of fitness
  •
  • How often do you currently participate in physical activity?*
  • If active, please list your activities down below*

  • Goal Setting

    In order to increase your chances of being successful at achieving your goals, I believe all your goals must be ‘SMART’ – Specific, Measurable, Attainable, Relevant, and Time calibrated. Tell me about your goals.
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  • Lifestyle and Behaviour Related Questions

    Your new workout routine
  • How many times per week would you like to train?*
  • What duration of training do you consider realistic, including warm-up and stretching?*
  • Would you prefer a program designed for the gym or for home training?*

  • Lifestyle and Behaviour Related Questions

    Nutrition
  • Do you drink at least 8 glasses of water each day?*

  • Briefly describe when you eat each meal and what you typically eat. 

  • Do you take vitamins or supplements?*

  • Lifestyle and Behaviour Related Questions

    Caffeine, alcohol & smoking
  • Do you smoke?*

  • Lifestyle and Behavior Related Questions

    Sleep, energy & stress
  •

  • Participant agreement

    Thank you for all the information. Next, please read and sign the release form below. (You will receive a copy by email once you have submitted the form)

  • I, {name}, wish to start a Personal Fitness Program with LAMISS FITNESS. I understand there are some risks in participating in a program of strenuous exercise. Consequently, I have been examined by a physician of my choice and obtained his/her approval for my participation in this program within sixty days of the date set forth below. No change has occurred in my physical condition since the date such approval was given which might affect my ability to participate in the fitness program.

    1. I certify that the answers to the questions outlined on the Physical Actitivity Readiness Questionnaire (PAR-Q) on page 2 of this form are true and complete to the best of my knowledge. I acknowledge that medical clearance is required if I have answered YES to any of the questions on the PAR-Q form.

    2. I understand and agree that it is my responsibility to inform my Personal Trainer of any conditions or changes in my health, now and ongoing, which might affect my ability to exercise safely and with minimal risk of injury.

    3. I understand that should I feel light headed, faint, dizzy, nauseated or experience
    pain/discomfort that I am to stop the activity and inform my Personal Trainer.

    4. I understand the results of any fitness program cannot be guaranteed and that my progress
    depends on my effort and cooperation in and outside of the Personal Training session.

    I have read this Release and Terms of Agreement and understand all of its terms. I sign it voluntarily and with knowledge of its significance.

  • ...and finally, some pictures

    I would like you to take some pictures of yourself. This will help us track your progress - change can happen fast and it is really important to have an accurate record of where you started.
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