Intake Form - Student Trainer Program

  • PERSONAL TRAINING AT TWU

    New Client Intake Form

  • Welcome to the TWU Student Trainer Program!  This program gives aspiring personal trainers at TWU the opportunity for real experience under the guided hand of experienced personal trainers.  Our student trainers have extensive education through the TWU School of Human Kinetics and additional training through the Student Trainer Program to prepare them to give you the best possible training experience.  In addition, each student trainer has a mentor who is certified personal trainer who will assist with your program as needed.  When it comes to offering personal training, we make every effort to provide opportunities for our student trainers so we will assign you with a student trainer who is the best match for you.  However, in some extenuating circumstances, we do have the ability the connect you with a certified personal trainer.  If you feel that is you, please let us know.

  • Welcome to Personal Training at Trinity Western University!

    Once you fill out this form, you will hear from someone within 48 hours to talk to you about your next steps.

    Thank you for your interest and we look forward to hearing from you.

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  • Are you part of the Dynamic Health Program?

  • The information that you provide is strictly confiential and is designed to match you up with a trainer that best meets your needs. 

  • Questionnaire

  • Do you consider yourself a healthy eater?
  • What would you consider your present attitude towards exercise
  • When you begin a program or set a goal, how likely are you to follow through to its fruition
  • What would you consider your present attitude towards goal achievement
  • Do you consider yourself to be active?
  • Do you currently play sports?
  • If yes check in the box which sports you play.

  • Medical History

  • Have you had a major injury or surgery?
  • Do you currently experience any physical limitations?
  • Do you smoke?
  • Is your blood pressure too high or too low?
  • Do you or a member of your family have diabetes?
  • Has your doctor ever said that your cholesterol was too high?
  • Are you pregnant or post-partum past 6 weeks?
  • Are you currently involved in a regular exercise program?
  • Do you consider yourself overweight?
  • Do you have cardiovascular problems(abnormal ECG, previous heart attack)?
  • Have you ever fainted or become dizzy with or without physical exertion
  • Have you had an injury to your back or knees?
  • Are you taking any prescribed medication or dietary supplements?
  • Date of last physical examination?
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  • What are your preferred training times?

  • Check preferred times
  • Trainer Preference
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  • Goals and Objectives

  • Check in the box your personal fitness goal(s)
  • What is the timeline you are hoping for achieving your goals?

  • Do you have some workout equipment available at home?
  • I would be willing/able to:
  • Should be Empty: