INTAKE FORM | PERSONAL TRAINING CLIENT

  • PERSONAL TRAINING:

    CLIENT INTAKE FORM
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  • TRAINING AVAILABILITY

    If you are a new client, please input all of your availability for training so that we can better match you with a Trainer.
    • Availability Specifications 
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  • HEALTH HISTORY

  • For most people physical activity should not pose any problem or hazard. The PAR-Q has been designed to identify the small number of adults for whom physical activity might be inappropriate or those who should have medical advice concerning the type of activity most suitable for them.

    If you are over the age of 69 and not used to being very active, check with your doctor.

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  • PHYSICAL ACTIVITY HISTORY & GOALS

  • PERSONAL TRAINING TERMS & CONDITIONS

    Client Agreement

  • I understand this Medical Health History Questionnaire has been provided for the purpose of helping me better understand any potential risks associated with a workout program. I also understand I should share this information with my physician and seek their approval prior to beginning an exercise program. I understand information I have provided will be maintained in my personal file for use in case of a medical emergency. My signature signifies that all of the above is true, to the best of my knowledge. Any information left unanswered was done so intentionally. If any of the above information changes, I agree to submit these changes in writing to the WellRec Personal Training Team. 

  • Clear
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  • **DONT FORGET TO COMPLETE PAYMENT**

    After submitting the client intake form, be sure to return to the previous tab to add this service to your cart and complete payment.

  • ATTENTION: ACTION ITEM

    This service includes a posture & movement screening and a body composition assessment. The results of these assessments will be used to deisgn your custom program. We will begin designing your program after this is completed. Please sign-up for an appointment timeslot HERE.


    Return to this form after you sign up for a assessment appointment.

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