Personal Trainer Initial Fitness Assessment
Personal Information
Full Name
Date of Birth
Phone Number
Email Address
Emergency Contact (Name & Number)
Medical History
Do you have or have you ever had:
Heart Condition
High Blood Pressure
Diabetes
Recent Injury
Asthma
Other
Current Medications
If yes to any, please provide details
Lifestyle
Occupation
How many hours do you sleep per night?
Stress Level
Low
Moderate
High
Goals
What are your main fitness goals?
Weight Loss
Tone Up
Build Muscle
Improve Endurance
General Health
Other
Please provide details on your fitness goals
Physical Measurements
Height (cm)
Weight (kg)
Body Fat (%)
Other measurements or notes
Current Activity Level
How would you describe your current activity level?
Sedentary
Lightly Active
Moderately Active
Very Active
What types of exercise or activities do you currently do?
Any current injuries or limitations?