TONE UP FOR YOUR WEDDING

Want to get in shape for your wedding? Then the FIT N FOCUSED Personal Training Bride to be Package is for you. Read more...

PRE EXERCISE QUESTIONNAIRE

Take our free online pre-training questionnaire and we'll contact you within 24 hours to discuss your health and exercise history, goals, diet and lifestyle. Click here...

BOX YOUR WAY TO FITNESS

Boxing training is beneficial for men and women of all ages. It provides a tremendous workout for the entire body and... Read more...

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Pre-exercise questionnaire

Pre-Exercise Questionnaire

 

Name:
Age:
Address:
Phone:
Mobile:
Email:
Emergency Contact Name:
Phone:
Why did you start training with us?
If Other, please write here

 

Health History

 

List any medications you are currently taking
Do you have diabetes?
Do you have epilepsy?
Have you had a stroke?
Have you had a heart attack or other heart condition?
Do you suffer from asthma?
Have you recently had surgery?
Are you pregnant?

Is there any other KNOWN physical reason that

prevents you participating in an exercise program?
List details here

Do you often feel faint or have spells of severe dizziness?

Has a doctor ever said you have high blood pressure?
Do you suffer any bone/joint/muscle problems?
List details here
Do you suffer any back problems?
List details here

 

General Goals

 

Improve strength/gain muscle/weight
If yes, list details here
Improve cardiovascular fitness
If yes, list details here
Improve muscle tone & shape
If yes, list details here
Lose weight/improve diet/eating habits
If yes, list details here
Reduce stress and increase energy
If yes, list details here
Improve and increase flexibility
If yes, list details here
Injury prevention/rehabilitation
If yes, list details here
Is there any area of your body that you want to specifically work on?
If yes, list details here
ANY Additional Goals

What specific health and fitness goals would you like to achieve?

 

Exercise History

 

Are you currently involved in cardiovascular activity?

If YES, What type and how often?

If NO, What cardiovascular activities do you enjoy?
Are you currently involved in resistance training?

If YES, How often?

If NO, How much time could you allocate to physical activity?

What is your current attitude to exercise?

Have you ever set a fitness or weight loss goal and failed to achieve results?

If YES, what factors got in the way of achieving your results?

 

Diet & Lifestyle

 

How satisfactory do you consider your diet to be?

In regards to a healthy lifestyle what are your biggest weaknesses?

How many meals a day do you have?

What time do you normally eat: Breakfast, Lunch and Tea

When do you snack?

What is the most common meal that you skip?

How many pieces of: Fruit and Vegetables do you eat a day

Rate your energy levels out of ten (ten being highest)

What time do you normally wake up in the morning?

Go to sleep?

How many hours of sleep do have a night?

Rate your quality of sleep (ten being highest)

How many hours a week do you work?

Do you have any current or past injuries that may affect your ability to exercise? What are they and how did they occur?

What forms of treatment have you had for these injuries?

Rate your satisfaction in your current physical state out of 10 (ten being highest)

In a couple of sentences detail why you are here?

List four things you would like to achieve over the next six weeks?

Over the next six months?

On a scale of 1-10 how important is it to you to achieve these goals (ten being most important)

What are some potential barriers in achieving these goals?

Can you think of some strategies to overcome these barriers?

What is the best time of day for you to exercise?

Where did you hear about Fit N Focused?

Declaration

I hereby represent to Fit N Focused, its management and employees that I am physically capable of and there are no medical reasons to prevent me from proceeding with the use of the studio/gym premises and any external activities conducted by Fit N Focused without endangering my health. I acknowledge that whilst on and off studio/gym premises (outdoor sessions); my person, my guests, my property, and my guest property are at my own risk. I acknowledge that I will not hold Fit N Focused and/or its trainers responsible for, to the extent permitted by law, all liability for any personal injury or damage (whether direct, indirect, special or consequential). I acknowledge that except as provided in this document Fit N Focused gives no warranties in respect of the facilities and equipment it provides. I hereby release and will indemnified Fit N Focused and its trainers for any injury or loss suffered by me whilst on the studio/gym premises or engaged in training sessions conducted externally.

By Clicking Submit you have accepted the Terms and Conditions

Date

Thank you for your co-operation