Personal_Training_Questionnaire_Fillable

Personal Training Questionnaire

Full Name

Date of Birth

Date

Age

Phone

Format: (000) 000-0000.

Email

example@example.com

Emergency Contact (Name & Phone)

Format: (000) 000-0000.

1 What are your top 3 fitness goals

2 Why are these goals important to you

3. Have you ever worked with a personal trainer before?YesNo If yes, what did you like or dislike?

If yes what did you like or dislike

1. Occupation: 2. Typical daily activity level: SedentaryVery active Lightly activeModerately active 3. Hours of sleep per night: 4. Stress level:Low ModerateHigh 5. Current exercise routine:

1 Occupation

3 Hours of sleep per night

5 Current exercise routine

Heart conditionHigh/Low blood pressure Diabetes Asthma/breathing issuesJoint or back pain Previous injuries/surgeries: Other medical conditions: Are you cleared by a doctor for exercise?YesNo

1. Eating habits:Healthy & balancedAverageNeeds improvement 2. Food allergies or restrictions:

2 Food allergies or restrictions

Preferences Strength 1. Preferred training style: 2. Preferred training environment:Gym 3. Days per week available to train:

Sports performanceMix Mobility

3 Days per week available to train

Commitment On a scale of 1-10, how committed are you to achieving your goals? 2 18910 34567

I confirm that the above information is accurate to the best of my knowledge. Client Signature:Date:

Client Signature

Date