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FITNESS CONSULTATION
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Date
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MM
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DD
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YYYY
Members Name
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Your answer
Is there anything specific that you would like to learn during our time together today?
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Your answer
Tell me about your current health goals and how long you think it will take you to achieve them.
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Your answer
Tell me about your current goals around nutrition (meals/day, types of food, etc.) and how we can help you with them.
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Your answer
What made you decide today was the day to start working towards these goals? What are some things in the past that have held you back from starting sooner?
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Your answer
On a scale of 1-10, (with 1 being not important and 10 being the most important) how important is reaching this goal to you? Why not lower?
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Your answer
Who do you have in your network to inspire you and hold you accountable?
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Your answer
Tell me about some habits that you think you will need help adjusting in order to reach your goals (Fast food, Starbucks, Alcohol, Sleep, etc.)
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Your answer
What do you currently do for recovery either post workout or when you're stressed?
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Your answer
When do you plan on coming into the gym? How many days per week? What days? What time?
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Your answer
In the next year, when the going gets tough and you're having a hard time coming in, what can we say to get you back on track?
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Your answer
Rank the following in the order that you think you need (1 being most and 3 being least important):
Accountability, Support, Guidance
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Your answer
Did they complete their Evolt Body Scan?
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Yes
No
Overhead Squat
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HIGH FIVE WARM-UP (Score the movements discreetly on a scale of 1-4. Use the scorecard to input score in notes section).
Choose
Pain Indicated
Movement is dysfunctional or cannot be completed
Movement is functional with compensation
Movement is functional without compensation
Overhead Squat Notes (Please Include scores for both left and right side of the body. Also include any concerns or observations in this section).
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Your answer
Split Squat
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HIGH FIVE WARM-UP(Score the movements discreetly on a scale of 1-4. Use the scorecard to input score in notes section).
Choose
Pain Indicated
Movement is dysfunctional or cannot be completed
Movement is functional with compensation
Movement is functional without compensation
Split Squat Notes (Please Include scores for both left and right side of the body. Also include any concerns or observations in this section).
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Your answer
Single-Leg Balance Reach (Score the movements discreetly on a scale of 1-4. Use the scorecard to input score in notes section).
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HIGH FIVE WARM-UP
Choose
Pain Indicated
Movement is dysfunctional or cannot be completed
Movement is functional with compensation
Movement is functional without compensation
Single-Leg Balance Notes (Please Include scores for both left and right side of the body. Also include any concerns or observations in this section).
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Your answer
Plank (Score the movements discreetly on a scale of 1-4. Use the scorecard to input score in notes section).
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HIGH FIVE WARM-UP
Choose
Pain Indicated
Movement is dysfunctional or cannot be completed
Movement is functional with compensation
Movement is functional without compensation
Plank Notes (Please Include scores for both left and right side of the body. Also include any concerns or observations in this section).
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Your answer
Bird Dog (Score the movements discreetly on a scale of 1-4. Use the scorecard to input score in notes section).
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HIGH FIVE WARM-UP
Choose
Pain Indicated
Movement is dysfunctional or cannot be completed
Movement is functional with compensation
Movement is functional without compensation
Bird Dog Notes (Please Include scores for both left and right side of the body. Also include any concerns or observations in this section).
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Your answer
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