Personal training - initial information
It's important for me to build a full picture of your current fitness levels, motivations for working with me as well as get some information on you overall health and injuries.

Please answer the questions below to the best of your knowledge. I will keep all information secure and it will not be shared without your permission.

Full Name *
Please give your first and last name
Your answer
Date of Birth *
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Email address *
Your answer
Phone number *
Your answer
Emergency contact name *
Your answer
Emergency contact number *
Your answer
GP name and contact number *
Your answer
Do you take any medication currently *
If yes, please give details here
Your answer
Has your doctor ever said that you have a heart condition and that you should only perform physical activity recommended by a doctor? *
Do you feel pain in your chest when you perform physical activity? *
Do you ever lose your balance because of dizziness or lose consciousness? *
Do you have a bone or joint condition that could be made worse by a change in physical activity? *
Is your Dr currently prescribing any medication for blood pressure or for a heart condition? *
Do you know of any other reason why you should not engage in physical activity? *
What kind of exercise do you really enjoy and why?
Your answer
What motivates you to exercise?
Your answer
What don't you like?
Your answer
Why?
Your answer
Have you worked with a personal trainer before
What are your main goals for working with a personal trainer?
Your answer
What are your barriers to exercise?
Your answer
Do you have any existing injuries or conditions to be aware of?
Your answer
Have you had any treatments and recommendations from other professionals?
Your answer
How much activity can you commit to each week?
Your answer
How would you describe your diet?
Your answer
What's your weekly average alcohol intake in units?
Your answer
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