Personal Weight Training Intake Questionnaire
Please complete this form to help us understand your fitness background, goals, and preferences for personalized weight training.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Age
*
What are your primary fitness goals?
*
Build muscle
Lose weight
Increase strength
Improve endurance
General health
Other
How would you describe your current physical activity level?
*
Sedentary (little or no exercise)
Lightly active (light exercise/sports 1-3 days/week)
Moderately active (moderate exercise/sports 3-5 days/week)
Very active (hard exercise/sports 6-7 days/week)
Do you have previous weight training experience?
*
No experience
Beginner (less than 1 year)
Intermediate (1-3 years)
Advanced (3+ years)
Please list any current or past injuries, medical conditions, or physical limitations.
Are you currently taking any medications that may affect your ability to exercise?
No
Yes (please specify below)
If you answered yes above, please specify the medications.
What are your preferred days and times for training sessions?
How motivated are you to commit to your training program?
*
1
2
3
4
5
Signature
*
Submit
Submit
Should be Empty: