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Personal Training Client Health History Form
Please answer each question. Your answers will be kept confidential.
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What is your name?
Your answer
What name do you preferred to be called?
Your answer
When is your birthday?
Your answer
What is your height?
Your answer
What is your current weight?
Your answer
Gender?
Female
Male
Prefer not to say
Other:
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What is your current address?
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What is your phone number? Please include cell, home, or work if applicable.
Your answer
What is your email address?
Your answer
What is your preferred way to be contacted (email/text/call)? Do you have a preferred time of contact (morning/afternoon/evening) or time of day you are usually unavailable? This is so that we can hold you accountable and for scheduling. We will do our best to contact you during your preferred times.
Your answer
Who is your employer?
Your answer
What is your occupation?
Your answer
In case of an emergency, who should we contact? Please include name, relationship, and phone number.
Your answer
How did you hear about me?
Your answer
What is your social media name?
Your answer
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