Fitness Questionnaire | Fitness with Benjamin

Contact

Email Name Date of Birth Phone Number Home Address Apartment, suite, or unit

City State ZIP

Preferred Communication Email Phone Text

Which coaching service are you interested in? Online coaching In-person training Hybrid online and in-person training

Readiness

Has your doctor ever said that you have a heart condition and that you should only perform physical activity recommended by a doctor? Yes No

Do you feel pain in your chest when you perform physical activity? Yes No

In the past month, have you had chest pain when you were not performing any physical activity? Yes No Maybe

Do you have a bone or joint problem that could be made worse by a change in your physical activity? Yes No Maybe

Do you know of any other reason why you should not engage in physical activity? Yes No Maybe

Goals

How long has it been since you were comfortable with your level of fitness? How did you feel at that time? What are your fitness goals, and why? How long have you been thinking about achieving these goals? What is motivating you to get started now? Do you have a timeframe for reaching your goals? How many days a week were you thinking of training? How flexible is your diet? What’s your daily nutrition like? Do you use fitness apps to keep track of your daily activities? If so, which apps? On a scale from 1 to 5, how ready are you to make consistent changes to your training?

Are you ready for a change today? Yes No Maybe

Lifestyle

What is your current occupation? Does your occupation require extended periods of repetitive movements? Does your occupation cause you anxiety or mental stress? Do you partake in any recreational activities? Do you have any hobbies? Have you had pain or injuries in your ankles, knees, hips, back, shoulders, or elsewhere? Have you ever had any surgeries? What time do you go to bed? What time do you wake up?

Training logistics

What workout equipment do you have at home?

Preferred days for training Monday Tuesday Wednesday Thursday Friday Saturday Sunday