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Personal Trainer Assessment Form
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Email
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Your email
Date:
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MM
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DD
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YYYY
Name:
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Your answer
Gender
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Your answer
Date of Birth
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MM
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DD
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YYYY
Address:
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Your answer
Emergency Contact (name, relationship, telephone #)
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Your answer
Telephone:
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Your answer
1.
What days are best for you to participate in the training program?
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Your answer
2.
What time of day is it best for you to participate in the training program?
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Your answer
3.
Body measurements (height, chest, waist, hips, arms, weight):Ht:_____ Ch:_____ W:_____ H:____ A:____ Wt:____lbs.
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Your answer
4.
Please describe your training goals briefly.
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Your answer
5.
How would you rate your motivation towards your training goals (low, medium, high, very high)?
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Choose
low
medium
high
very high
6.
What is the main motivating factor behind you joining a training program?
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Your answer
7.
Are you satisfied with your weight? If not, what body weight would you like?
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Your answer
8.
Are you motivated enough to follow a rigorous training regime for up to 2 months with a controlled diet?
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Your answer
9.
Have you been training in the last year? If yes, please describe any improvements in your fitness level.
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Your answer
10.
What are the main things that you are looking forward from the training program?
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Your answer
11.
How many months are you ready to spend to achieve your objectives?
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Your answer
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