Pre Training Questionnaire

Pre-training questionnaire

The information obtained during this fitness evaluation will be treated as confidential and will not be released or revealed to anyone without your consent. Your right to privacy is my prime concern.

Personal details

* Name

First

Last

* Date of Birth

* Email address

* Phone number

Occupation

* Address

Street Address

Address Line 2

City

State / Region / Province

ZIP / Postal Code

Country

Emergency contact

* Name

First

Last

* Phone number

All information will remain confidential and enables us as your Personal Trainer to modify and personalise your program.

Are you taking any prescribed medication?

Do you have any allergies?

Is there any other condition that might be reason to modify your exercise program?