Personal Training Questionnaire
Fill out this for a free personal training session.
Email address *
*
Name: *
Your answer
Email: *
Your answer
Phone: *
Your answer
How often do you exercise? *
Where do you currently work out? *
Your answer
How long do you usually work out? (In minutes) *
Your answer
Have you ever trained with a personal trainer? *
Why are you interested in a personal trainer? *
Your answer
Would you work out on days when you could not meet with a trainer? *
What type of fitness do you enjoy? (Check all that apply) *
Required
Describe your current exercise routine, if any: *
Your answer
Which area do you want to focus on? *
Your answer
How many times per week would you be interested in seeing a personal trainer? *
Do you have a significant other / close friend who supports your fitness goals? *
How would you rate health in your life? *
Do you feel that making lifestyle changes will improve your quality of life and decrease your risk of health-related disorders? *
Are you willing to make lifestyle changes to adhere to your goals? *
How important is it for you to achieve your fitness goals? *
Not Important
Very Important
Describe your number one fitness goal: *
Your answer
What do you think you need to do to achieve this goal? *
Your answer
What is the biggest challenge you face in reaching your goal? *
Your answer
What do you hope to learn from personal training? *
Your answer
Have you had any major weight fluctuations in the past year? *
Has a physician recommended you start working out? *
Are you taking any medications or drugs? If yes, please list *
Your answer
Do you now, or have you had in the past (treatment, diagnosis): Please check: *
Required
On a scale of 1 -5, please rate your stress level *
No Stress
High Stress
What areas gives you the most stress? *
How many meals do you eat in a day? *
Do you start your day with breakfast? What do you normally eat? *
Your answer
What is your largest meal of the day? *
Describe what you typically eat in one day: *
Your answer
How many glasses of water do you drink in one day? *
Have you ever been on a weight loss program? If yes, please explain the diet and how long you were on the program. *
Your answer
Please provide 3 times you are available for training *
Your answer
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