CERTIFIED PERSONAL TRAINERS SERVING THE CHICAGO METRO AREA AND SUBURBS


Your Contact Details








The following questions will help me better understand your needs when we speak further about your Health & Fitness goals.

How many days a week can you commit? 1-2 3-4 5-6

How much time each session? 1/2 - 1 Hour 2 Hour 3 Hour

Are you physically active now? Yes No

Do you belong to a health club? Yes No

Have you ever had a personal trainer? Yes No














What are your goals?
Flexibility
Build
Tone
Strength
Sports improvement
Endurance

Have you been diagnosed with a Heart Condition? Yes No

Have you or do you ever feel Faint or Dizzy? Yes No

Have you ever-experienced Pain in your Chest? Yes No

Do you or have you ever had High Blood Pressure? Yes No

Do you or have you ever had High Cholesterol? Yes No

Do you suffer from Allergies or Asthma? Yes No

'Have you ever had any Bone or Joint problems? Yes No

Are you taking any Medication? Yes No