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- Date of Birth*
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- What kind of training are you looking for?*
- Do you have a gym membership at Crunch?*
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- Which days of the week work best for you?*
- What times of day work best for you?*
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- What equipment do you have access to outside our sessions?*
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- Has your doctor ever said that you have a heart condition OR high blood pressure?*
- Do you feel pain in your chest at rest, during your daily activities of living, OR when you do physical activity?*
- Do you lose balance because of dizziness OR have you lost consciousness in the last 12 months? (Please answer NO if your dizziness was associated with over-breathing, including during vigorous exercise.)*
- Have you ever been diagnosed with another chronic medical condition (other than heart disease or high blood pressure)?*
- Are you currently taking prescribed medications for a chronic medical condition?*
- Do you currently have (or have had within the past 12 months) a bone, joint, or soft tissue (muscle, ligament, or tendon) problem that could be made worse by becoming more physically active? (Please answer NO if you had a problem in the past, but it does not limit your current ability to be physically active.)*
- Has your doctor ever said that you should only do medically supervised physical activity?*
- Are you currently pregnant or postpartum (within 6 months)?*
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- Should be Empty: