Hilary Hall Fitness New Online Client Assessment
Please answer the following questions to your best ability. 
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Email *
Full Name *
Phone Number *
Emergency Contact (Name and Number) *
Age *
DOB *
MM
/
DD
/
YYYY
Height *
What would you like to accomplish in our first 6wks together? (Short-term goal) *
What are your long-term goals?  *
Do you have any previous injuries or restrictions that I should know about?  *
Do you have your doctor's clearance?  *
Check your tracking apps *
Required
How many days a week can you realistically workout weekly?  *

Rate these categories in order of importance: Use a 1-5 scale

Weight Loss___________ 

Strength Gain___________ 

Muscle Gain___________ 

Mobility Improvement___________ 

Postural Improvement___________

 *
Most Important! (5)
Important (4)
Fairy Important (3)
Somewhat (2)
Not really important (1)
Weight (Fat) Loss
Strength Gain
Muscle Gain
Mobility Improvement
Postural Improvement
List all workout equipment you have at home. Being as detailed as possible helps me to personalize your program. If you have dumbbells list the weights you have.  *
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