C&J Personal Training Questionnaire
Thank you for your interest in C&J Personal Training. Below you will find a fitness questionnaire used to gather essential information about your exercise background, health history, lifestyle habits, and goals before beginning training. The questionnaire is a critical tool for designing safe, effective, and individualized programs. The information you provide allows us to better understand your current fitness level, identify any limitations or risk factors, and create a plan tailored specifically to your needs and goals. Your responses will remain confidential and will help ensure that your training experience is both productive and aligned with your long-term health and performance objectives.
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Last Name *
First Name *
Gender *
Age *
Cell Phone *
Email *
Exercise History - Current Activity Level *
Exercise History - Current Exercise Routine (Check all that apply)  *
Required
Exercise History - How many days per week do you exercise? Duration of session? How long have you consistently been exercising?  *
Exercise History - Have you worked with a personal trainer in the past?  *
Exercise History - If yes to above question, what did you enjoy most about past training? What did you dislike or find challenging?
Exercise History - What are your primary fitness goals? (Select all that apply)  *
Required
Exercise History - Why are these goals important to you?  *
Exercise History - Do you have a specific timeline or event?  *
Exercise History - How many days can you realistically commit to training?  *
General Health - Do you have any diagnosed medical conditions? *
General Health - Do you have any diagnosed medical conditions? If yes, please specify.
General Health - Are you taking any medications? *
General Health - Are you taking any medications? If yes, please specify.
Injury History - Have you had any major injuries or surgeries? *
Injury History - Have you had any major injuries or surgeries? If yes, please specify. 
Injury History -  Do you have any chronic issues (back pain, knee pain, shoulder pain, etc.)? Please Specify. 

 *
Cardiovascular Risk Factors - Has a doctor ever told you that you have: *
Required
Cardiovascular Risk Factors - Do you experience: *
Required
Cardiovascular Risk Factors - Family history of heart disease before age 55 (male relative) or 65 (female relative)? *
Lifestyle - Average sleep per night: *
Lifestyle - Average Water Intake Per Day *
Lifestyle - Average steps per day (if known): *
Lifestyle - Do you smoke?  *
Lifestyle - Alcohol Consumption per week:  *
Lifestyle - Occupation *
Lifestyle - On a scale of 1–10, how would you rate your daily stress? *
Required
Lifestyle: Main sources of stress: *
Required
Final Question - What motivates you most?
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