Client Info
In order to create a customized health improvement plan, I will take into account your current and previous health status, current lifestyle, goals and interests. This will give you the most benefit and results from the program. Please answer all questions as accurately and concise as possible.

If a question does not apply to you, please enter NA.

Please recognize the fact that it is your responsibility to work directly with your physician before, during, and after seeking fitness consultation. As such, any information provided is not to be followed without the prior approval of your physician. If you choose to use this information without the prior consent of your physician, you are agreeing to accept full responsibility for your decision.
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