Info Sheet - Personalized Fitness For You

WE NEED SOME INFO FROM YOU

Document 1 of 3 – You got this!

Name*
First Last
Date*
MM slash DD slash YYYY
Email*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Which is the best way to contact you?*
In case of emergency, who would you like me to contact?*
First Last
What is your emergency contact's phone number?*
Does this person know he/she is your emergency contact?*
- Yes
- No
Do you currently exercise? If yes, what is your routine?*
Are there any past or present injuries that I should be aware of?*
Are you in poor, good or great health?*
How would you rate your stress level on a scale of 1-10 (10 being the highest)?*
Do you enjoy the outdoors?*
What are some of your hobbies?*
Have you had any surgeries in the past 5 years that are important to share?*
Do you have any allergies?*
Are you taking any medications that affect your heart rate?*
- Yes
- No
What are your top three fitness goals?*