Fitness client profile questionnaire
CLIENT PROFILE QUESTIONNAIRE
NAME: _______________________________________
DATE:___________________________________________
CELL NO. _____________________________________
EMAIL: _______________________________________
IN CASE OF EMERGENCY, CALL:_______________________
ADDRESS:
_____________________________________________________________________________________
CITY: ________________________________________ STATE: ________________ ZIP:
__________________________
GENERAL HEALTH & NUTRITION QUESTIONS
Personal Profile Information
Gender: ! Male ! Female Height: _____ / _____ Birth date:
_____/_____/_______
Weight NOW: _______ Goal Weight: _______ Body fat % _______
Weekly Exercise Information
Explain in detail what type of resistance exercises, cardiovascular or sports activities you perform on
average during a 7-day period.
Exercise/Activity Days/week Duration
____________________________________________ _________ ________
____________________________________________ _________ ________
____________________________________________ _________ ________
____________________________________________ _________ ________
____________________________________________ _________ ________
____________________________________________ _________ ________
Lifestyle / Professional Activity
How would you rate the activity level of your profession, or what you do during the day (non-exercise
related).
! Sedentary ! Moderately Active ! Active ! Very Active
What are your goals?
! Weight Loss ! Improve Eating Habits ! Gain Weight What is your goal weight? _____
! Improve Strength ! Improve Flexibility ! Improve Cardiovascular Fitness
! Improve Flexibility ! Maintain Fitness Level ! Improve Fitness Level
! Understand how to perform exercises ! Making Exercise a priority 3-5 times a week ! Making Exercise
a priority 2-3 times a week
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Fitness client profile questionnaire
DOC: 78.7 KB | PDF: 66.0 KB (3 pages)
( 4.8, 17 votes )
Fitness client profile questionnaire
DOC: 78.7 KB | PDF: 66.0 KB (3 pages)
( 4.8, 17 votes )
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