Health and Fitness Assessment Request Form

Request edit access

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

The Fitness Assessment is a group of comprehensive tests that will evaluate your physical health and intentions/attitudes towards exercise. The assessment lasts approximately 30 minutes and provides baseline information on your current body composition, cardiovascular endurance, flexibility, and muscular strength. This consultation can be used as a standalone baseline health test, or is a prerequisite to starting personal training.

Please list several days/ times available for an assessment, and we will try our best to match you with a trainer or Pro staff member for that time frame. Please know that all times requested may not be available immediately, and based on demand there may be a wait on your appointment. We will do our best to schedule your appointment in timely manner.

For any questions about Fitness Assessments please contact Danielle Stone (dstone@iwcc.edu) #712-325-3701.

First Name *

Last Name *

Email *

Phone Number *

Would you like a personalized workout routine you can do on your own, or to discuss Personal Training options in addition to your Fitness Assessment? *

I would just like an assessment to establish my baseline for activity.

I would like to get a personalized workout emailed to me after my assessment. I understand that this workout is for me, and that I will do the workout on my own time.

I would like to schedule follow up sessions with a personal trainer to lead me through custom workouts after my assessment.

Please list several potential dates and times that work best for you to come in and have a fitness assessment/consultation. *

Any health issues you would like our staff to be aware of please list here *

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Forms