Health & Medical History

Go through the below questions and mention yes / no or anything to specify.

Do you have any medical conditions? (e.g., heart disease, diabetes, asthma)

Are you currently taking any medications?

Have you had any surgeries or injuries in the past?

Do you have any allergies?

Lifestyle Information

What is your current occupation?

How many hours do you work per week?

How many days per week do you exercise?

What types of physical activities do you enjoy? (e.g., running, weightlifting, yoga, etc.)

What is your primary goal for fitness? (e.g., weight loss, muscle gain, endurance, general health, etc.)

Fitness Assessment

How would you rate your current fitness level? ( Beginner / Intermediate / Advanced )

What specific challenges or barriers do you face in achieving your fitness goals?

Do you have any preferences for training styles or methods? (e.g., group training, one-on-one, outdoor workouts, etc.)

Nutrition & Eating Habits

How would you describe your current eating habits?

Do you have any dietary restrictions or preferences? (e.g., vegetarian, vegan, gluten-free, etc.)

How many meals do you typically eat in a day?

Do you use any supplements? if yes please specify.

Additional Information

Is there anything else you would like me to know that could help in creating your fitness plan?

Consent and Agreement

I understand that the information provided in this form will be used to create a personalized fitness plan. I agree to inform my fitness consultant of any changes to my health status.

Signature

Signature field is empty.

Date picker