Fitness Trainer Health Evaluation Form
Please complete this form to help your fitness trainer understand your background, goals, and preferences before training begins.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Date of Birth
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Primary Fitness Goals
*
Current Activity Level
*
Sedentary (little or no regular activity)
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
Known Injuries or Physical Limitations
Current Medications or Relevant Health Notes
Preferred Training Schedule / Availability
*
Additional Comments or Concerns
Submit
Should be Empty: