Health & Wellness Assessment Questionnaire

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Please fill out the following questions to help us get to know a little about you prior to the assessment. The assessment fee will be credited upon purchasing a package if you decide to move forward with your coach.

Email *

Name *

Phone number *

Branch / Location where you want to train *

Sacramento

Woodland

Rollingwood

Virtual

Required

Which Service(s) are you interested in?

Personal Training

Health Coaching (Rollingwood and Woodland branches only)

Both

Availability: Please list dates and times you are available the next two weeks. *

Mornings

Afternoons

Evenings

Required

Interested in *

1:1 Personal Training

2:1 Semi-Private Training

Both

Trainer Preference *

Male

Female

No Preference

Overall Goal of Personal Training *

Any past medical conditions that will affect exercise?

Have you ever had a heart attack or stroke?

Are you on any blood pressure medications?

Any past injuries or health concerns that you would like your Trainer to know prior to your consultation? *

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