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In Person Training Application
Interested in 1 on 1 personal training at Misfit Strength Studio? Fill out this form to get started!
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Email
*
Your email
Name
*
Your answer
Address
Your answer
Phone Number
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Your answer
Age/birthdate
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Your answer
How do you identify?
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transgender
male
non-binary
female
prefer not to say
Other:
If you answered other in the previous question, please describe.
Your answer
What are your pronouns?
Your answer
What are your 3 main goals? Please be as specific as possible.
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Your answer
Why do you want to achieve these goals? Again, please be as specific as possible.
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Your answer
What do you think are your challenges in achieving these goals?
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Your answer
Have you tried to reach these goals before? What happened?
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Your answer
What is your plan for when you reach your goals?
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Your answer
What is your motivation level right now?
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low
moderate
high
What is your current activity level?
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Sedentary: Desk job or not working with little to no exercise
Little Activity: Exercise moderately 1–3 times a week. Or no exercise, but slightly active job.
Moderate: Exercise moderate 2-3 times a week with sedentary job. Or slightly active job, and exercise moderately 1-3 times a week.
Active: Physical work, exercise hard 5+ days a week
Highly Active: Physical work, exercise very hard 6+ days a week
What is your previous exercise experience? Type, frequency, time frame. Did you enjoy it?
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Your answer
Are you currently exercising? If so, what and how frequently.
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Your answer
Do you have any exercise limitations? If yes, please describe.
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Your answer
Do you have any current or recurring joint, muscle, tendon or ligament pain? Where?
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Your answer
Do you have any current or past injuries? If yes, please describe.
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Your answer
Do you experience any pain or discomfort during exercise?
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Your answer
Have you lost or gained a large amount of weight before? Please describe.
Your answer
Do you, or have you ever had disordered eating?
Your answer
Do you have any medical/health issues?
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Your answer
Are you pregnant?
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Yes
No
Maybe
Are you breast/chest feeding?
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Yes
No
Do you have stress incontinence?
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Leaking of urine when coughing, sneezing, jumping, running, etc.
Frequently
Occasionally
Rarely
Never
Do you have urge incontinence?
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Leaking of urine when the bladder is full
Frequently
Occasionally
Rarely
Never
Do you have anal incontinence?
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Inability to hold in gas and/or stool
Frequently
Occasionally
Rarely
Never
Do you have diastasis recti?
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separation of the abdominal muscles
Yes
No
Unknown
Do you or have you ever had a hernia?
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Yes
No
Do you have pelvic organ prolapse?
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Uterine (uterus)
Cystocele (bladder)
Rectocele (rectum)
None
Required
Is there anything else you would like us to know about you?
Your answer
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