Online Questionnaire
(All responses are kept confidential.)
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Name *
Age *
Height *
Weight *
Email *
Phone Number
Previous exercise history (sports, weightlifting, etc.) *
Are you currently exercising? If so, how long have you consistently been exercising? *
In the past several weeks have you been dizzy, found yourself short of breath or unusually fatigued, or had any pain or discomfort in your chest or upper body? *
Have you had any injuries in the past? (If so, please list them.) *
Do you have or have you ever had any serious medical conditions? (If so, please list them.) *
Are you taking any medications or performance enhancing drugs currently? (If so, please list them.) *
What are your goals? (short and long term) *
What are the biggest obstacles that have kept you from reaching those goals?
Is there anything specific that I can do to help you reach your goals?
How much sleep do you normally get? *
How many days a week do you plan on training? *
How much time will you have to train? *
Are there any specific exercises you would like to get better/not do at all?
What does a normal day of eating look like for you? (Do you know how many calories you consume?)
How do you spend most of your days?
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If you are interested in in-person personal training, what are the best times to meet for you?
What prompted you to look for a trainer?
Have you ever had a personal trainer before?
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Please list below any questions you may have.
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