PRE-FITNESS ASSESSMENT QUESTIONNAIRE 

Name

Telephone

Email Address

Date of Birth

Gender GenderMaleFemale

Height

Weight

How often do you you exercise? How often do you you exercise?Once a weekLess than 3 times a weekMore than 3 times a weekNever

How long do you you exercise? How long do you you exercise?10-20 minutes20-40 minutesMore than 40 minutesNot at all

Which type of exercise do you do mostly? Which type of exercise do you do mostly?CardioStrengthFlexibilityAll of the above

What is your fitness goal?

Do you have ANY medical conditions that restrict your exercise in any way? Do you have ANY medical conditions that restrict your exercise in any way?NoYes

If you answered YES above, please provide details. Is there any additional, relevant information you'd like to share?