Personal Training Questionnaire
Our personal training program is unique! Our certified trainers practice “Exercise Prescription” which is the process of writing an individualized program to meet the goals of each client. During the first session, the client and trainer discuss the client’s goals, and the client is taught various exercises to reach his/her goals.

The client takes home a written program to work for a period of time.  Follow –up visits are scheduled for evaluation and program adjustment, as needed.

Personal Training sessions are $50 per one hour session. This includes a guided workout with our certified personal trainers and prescribed personal workouts to do on your own time. You will be required to pay before your session.
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First Name *
Last Name *
Email Address *
Phone Number *
Best way to contact:
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Date of Birth *
Being physically active is safe for most people. Some people, however, should check with their doctors before increasing their current level of activity. The next few questions have been designed to identify the small number of adults for whom physical activity may be inappropriate or those who should have medical advice concerning the type of activity most suitable for them.
Has your doctor ever said that 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 your balance because of dizziness or do you ever lose consciousness? *
Do you have a bone or joint problem that could be made worse by a change in your physical activity? *
Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition? *
Do you know of any other reason why you should not do physical activity? *
If you answered yes to one or more questions, are older than age 40, and have been inactive or are concerned about your health, consult a physician before substantially increasing your physical activity. Ask for a medical clearance along with information about specific exercise limitations you may have. In most cases, you will still be able to do any type of activity you want, as long as you adhere to some guidelines.
Current activity level
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What is your current preferred mode of exercise?
How often do you currently exercise?
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Do you have any health concerns of medications your trainer should be aware of? (this includes any recent or current injuries, personal or family history of disease, pregnancy, etc.)
Which of the following best describes your exercise goals? (Check all that apply)
Do you have a specific timeline for any of your goals?
Where are you planning to primarily do your personal workouts?
How many days per week do you want to workout?
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What times are best to meet with a trainer? (Check all that apply)
Is there anything else you would like your personal trainer to know?
Do you have a specific trainer you want to work with?
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