Functional Strength Training Assessment Form
Please complete this assessment to help us evaluate your current functional strength and tailor your training program accordingly.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Age
*
Gender
*
Male
Female
Non-binary
Prefer not to say
How would you describe your current physical activity level?
*
Sedentary (little or no exercise)
Lightly active (light exercise 1-3 days/week)
Moderately active (moderate exercise 3-5 days/week)
Very active (hard exercise 6-7 days/week)
Other
What are your main goals for functional strength training? (Select all that apply)
*
Increase overall strength
Improve mobility/flexibility
Enhance athletic performance
Reduce risk of injury
Rehabilitation/post-injury
Weight management
Other
Please rate your current ability in the following areas:
*
Rows
Mobility
Core Strength
Upper Body Strength
Lower Body Strength
Balance & Coordination
Poor
1
2
3
4
5
Fair
6
7
8
9
10
Good
11
12
13
14
15
Very Good
16
17
18
19
20
Excellent
21
22
23
24
25
Do you have any current or previous injuries or medical conditions that could affect your training?
*
No
Yes (please specify below)
If yes, please specify your injuries or medical conditions:
How would you rate your motivation to begin or continue strength training?
*
1
2
3
4
5
Please describe any previous experience with strength or resistance training:
Submit Assessment
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