Personal Training Questionnaire
Please answer the following questions to provide us with your information and preferences.
GENERAL INFORMATION
Your Name *
Your answer
Email Address *
Your answer
EBF Location *
DESIRED DAYS & TIMES
Please check off all times/days that you are available for Training
MORNING
LUNCHTIME
EVENING
MON
TUES
WEDS
THURS
FRI
SAT
SUN
YOUR GOALS & PREFERENCES
Reason(s) for Seeking Personal Training
Your answer
Goal(s) for Personal Training
Your answer
Trainer Preference
Let us know if you would like to work with a specific Trainer
Your answer
Desired Frequency *
How often would you like to Train?
Your answer
MEDICAL INFORMATION
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 (for example, back, knee or hip) 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? *
Please describe any injuries or physical limitations you may have
Let us know your medical/injury history
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of EverybodyFights.