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Fitness Assessment
To determine personal history such as occupation, lifestyle, and
medical background, as well as physical activity readiness. Any information that you share with us is safe with us and will never be shared with anyone else with no exceptions.
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* Indicates required question
Email
*
Your email
1. What is your name?
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Your answer
2. What is your date of birth?
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MM
/
DD
/
YYYY
3. What is your gender?
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Male
Female
Other:
4. What is your current weight?
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Your answer
5. How long have you been at that weight?
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Your answer
6. What is your goal? How much pounds of fat would you want to lose?
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Your answer
7. What is your height?
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Your answer
8.
What is your current occupation?
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Your answer
9.
Does your occupation require extended periods of sitting?
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Yes
No
10.
Does your occupation require extended periods of repetitive movements? (If yes, please explain.)
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Your answer
11.
Does your occupation require you to wear shoes with a heel (dress shoes)?
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Yes
No
12.
Do you have any recreational activities (golf, tennis, swimming, etc.)? (If yes, please explain.)
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Your answer
13.
Do you have any hobbies (reading, gardening, working on cars, etc.)? (If yes, please, explain.)
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Your answer
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