Name
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First Name
Last Name
Email
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What is your height?
What is your age?
What is your gender?
What is your occupation?
What is your current weight?
How do you spend the majority of your time at work? (E.g. sitting, active, driving, etc.)
How many hours on average do you work per week?
Have you ever had a personal training session?
What is your experience level in fitness training?
Do you currently exercise?
How often do you exercise?
When you exercise, how long is each session?
How long have you been training/exercising?
What type of exercise do you do? (E.g. Yoga, weight training, running, etc.)
What are your favorite exercises and why?
What are your least favorite exercises and why?
Where do you exercise? (E.g. Gym, park, at home, etc.)
What fitness equipment do you have access to? Please list all.
Do you currently participate in any athletic events? If so, what type?
How would you characterize the stress level of your lifestyle?
What is your major goal? (E.g. weight loss, muscular strength, increase flexibility, etc.)
What are your top three fitness goals?
How much time will you have to exercise per session?
Are there specific body parts that you want to primarily focus on?
How long before you wish to see results?
What barriers may you face during your training program? (E.g. long work hours, transportation, etc.)
What will motivate you to achieve your goals?
Are you currently pregnant?
Has your doctor ever said 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 balance because of dizziness or do you ever lose consciousness?
Do you have a bone or joint problem (for example back, knee, or hip) that could be made worse by a change in your physical activity?
Is your doctor currently prescribing medication for your blood pressure or heart condition?
Do you know of any other reason why you should not take part in physical activity?
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