Please fill out all the necessary information. You will be contacted by
our friendly staff upon completion.
Before we embark on our fitness, health or nutrition journey we at fitnesstrainingformenandwomen.com would like to know a little bit more about you. We will use this information to customize your experience with us. In addition, if you have any medical concerns or if you need doctor's clearance before participation this is your chance to let us know. We value your health and fitness so please don't hold back, no information about you is unimportant. Thanks sincerely for taking the time to help us help you look and feel better.
Questionnaire
Client Submission Form
Name (First ) (Last)
Address
City Province/State
Country Postal/Zip Code
Phone Email Address
When was the last time you exercised?
What did you do and for how long?
What if any would you like to change about your physical state?
What is your current weight, height & age?
Where do you think you need the most help?
What if any diet have you tried?
What's your occupation and is it stressful?
What are your alcohol, caffiene and cigarette habits?.
How much sleep do you get?.
Any Heart problems or medical issues?.
What medication or supplements are you taking?.
Is there any reason you cannot exercise vigorously?
Describe what you eat in a typical day.
How did you hear about us? (Indicate bonus if any)
What program/programs are you interested in?
