Fitness Questionnaire

Contact

Email Name Date of Birth Phone Number Home Address

Preferred Communication Email Phone Text

What type of coaching are you interested in? One-on-one private coaching Online coaching Not sure yet

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? Why have you waited? What is different this time? What is your plan for achieving these goals? 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 DTF, dedicated to fitness, are you?

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 ever had any pain or injuries? Have you ever had any surgeries? What time do you go to bed? What time do you wake up?

Training logistics

Are you able to train at Castro Fitness, Market Street? Yes No

What workout equipment do you have at home?

Availability by day Monday Tuesday Wednesday Thursday Friday Saturday Sunday

Availability by time Anything else I should know about you?

Contact

Readiness

Goals

Lifestyle

Training logistics