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Pride Training
Client Health Questionnaire
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Full Name *
Phone Number *
Height/Weight *
Age *
Date of Birth *
Email *
What is your occupation? *
Any bone or joint problems? *
Have you ever had any surgeries that may impact your ability to exercise? *
Required
Do you have a history of high blood pressure or cholesterol? *
Do you have any limits to physical activities? *
Are you currently taking any type of medication? If yes, please list. *
Required
Are you taking any supplements? If yes, please list. *
Required
What are your hobbies? (Reading, gardening, working on cars, etc.)
What are your recreational activities? (Golf, football, basketball, etc.)
Please list any food allergies that you may have.
Please check all that apply *
Required
What are your favorite foods? (fruits, veggies, meats, etc.) *
What are your least favorite foods? *
What is your favorite exercise? *
What is your least favorite exercise? *
Do you know if any reason why you should not engage in physical activity? *
What are your fitness goals? *
What are your expectations from your trainer? *
Additional comments, questions, or concerns.
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