Employee Fitness Training Plan Assessment Form
Assess your current fitness level, training needs, and preferences to help plan an effective workplace fitness program.
Employee Full Name
*
First Name
Last Name
Department or Role
*
Current Physical Activity Level
*
Sedentary (little to no exercise)
Lightly active (light exercise 1-3 days/week)
Moderately active (moderate exercise 3-5 days/week)
Very active (intense exercise 6-7 days/week)
What are your primary fitness goals?
*
Weight management
Increase strength
Improve cardiovascular health
Increase flexibility/mobility
Reduce stress
Other
Do you have any health conditions or injuries that should be considered when planning your fitness program?
*
No
Yes (please specify below)
If yes, please specify your health condition or injury (leave blank if not applicable).
Preferred Training Frequency
*
1-2 times per week
3-4 times per week
5 or more times per week
What times are you generally available for workouts?
*
Before work
During lunch break
After work
Weekends
Which types of exercise do you prefer?
*
Cardio (running, cycling, etc.)
Strength training (weights, resistance)
Yoga/Pilates
Group classes
Outdoor activities
Other
How would you rate your current overall fitness?
*
1
2
3
4
5
Fitness Attitudes and Confidence
*
Rows
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I feel confident using exercise equipment
1
2
3
4
5
I am motivated to improve my fitness
6
7
8
9
10
I have enough time to exercise regularly
11
12
13
14
15
I enjoy being physically active
16
17
18
19
20
Trainer Recommendations / Next Steps
Submit Assessment
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