Goals & Planning

1.  What type of training are you looking for?  Select from the options below:

   Lose Weight               Develop Muscle Tone       Gain Weight

 

   Increase Strength       Develop Flexibility            Increase Cardio
 

Please explain:

2.  What type of physical activity are you currently involved in? Select from the options below:

   None                           Recreational walking / jogging       Competitive Sports

 

   Weight Lifting            Aerobic / Cardio Organized program      Other

Please give a brief description:

3.  Please list any know medical conditions you have that may effect your ability to exercise.  Include any conditions that you have received medial treatment for in the past 3 years. 

    Are you taking any prescribed or non-prescribed drugs or medications?

    - Select One - Yes No       

 If Yes, please describe:     

    Are you a smoker?

   - Select One - Yes No       

 If Yes, please describe:     

    Do you have any physical limitations that may effect your ability to exercise?

   - Select One - Yes No       

 If Yes, please describe:     

    Please list any conditions you have received medical treatment for in the past 3 years?

Scheduling

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1.  What days are you available for personal training?

   Sunday Select Time Early Evening (3pm - 6pm) Late Evening (6pm - 8pm)             Tuesday   Select Time Evening (6pm - 8pm) Late Evening (8pm - 9pm)

  Thursday   Select Time Evening (6pm - 8pm) Late Evening (8pm - 9pm)          Friday   Select Time Evening (6pm - 8pm) Late Evening (8pm - 9pm)

  Saturday   Select Time Afternoon (12pm - 3pm) Early Evening (3pm - 6pm) Late Evening (6pm - 9pm)

2.  What date would you like to begin?      

Approximately how many sessions?    Select One 1 - 2 2 - 3 3 - 4 4 or more

3.  Are you interested in becoming a member of the Fitness Program.  - Select One - Yes No

Click Here for more information on the Fitness Program

Use the space below for comments / questions.