Do you have any health condition that would put you at risk
while following a strict diet or exercise program (such as diabetes,
high blood pressure, heart condition, pregnancy , etc.)?
No
Yes. Please name condition(s):
What do you want the product of your training to be (ex.:
a beautiful physique, greater health and vitality, etc.)?
Why?
On a scale of 1 to 10 , rate your commitment to the goal of
achieving the body of your dreams:
1 2 3 4 5 6 7 8 9 10
Last regular exercise was
months ago.
How often?
What do / did you do?
What is the amount of time in days and hours that you are
willing to commit to physical training?
How often do you normally involve yourself in aerobic activity?
What is your favorite form of aerobic activity?
How often do you train with weights and for how long?
How many calories do you think you consume in a normal day?
How many meals do you eat in a normal day?
Do you often feel hot or cold?
No
Yes
Are your hands or feet often cold?
No
Yes
Do you itch or sneeze after eating fruit?
No
Yes
If yes, what kind?
Are you lactose intolerant?
No
Yes. What severity? Please describe:
Do you suffer from poor digestion or gas?
No
Yes. When?
Please list everything you have eaten for the past two days
Yesterday
Day Before
By clicking Submit, you agree that you have read, and agreed
to, the Personal Trainer Agreement.
In addition, you agree that the above information is accurate
and complete to the best of your knowledge and you commit to following
the advice of your trainer completely.
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