Personal Training Agreement A

Personal Training Policy And Service Agreement:

* Indicates required field

Name *

First

Last

Email *

Phone Number *

Health and Medical Information
The Client agrees to disclose any relevant medical conditions, injuries, or medications. The Client is responsible for obtaining medical clearance if necessary.

What is your age? *

Less than 13 13-18 19-25 26-35 36-50 Over 50

Have you ever been diagnosed with any of the following medical conditions? (Check all that apply) *

Heart disease or angina High blood pressure Diabetes Asthma Arthritis Osteoporosis Chronic back pain Joint injuries/surgeries None

Are you currently taking any medications? (Include both prescription and over-the-counter medications) *

Yes No

If yes, please specify: *

Have you ever had any surgeries or major injuries? *

Yes No

Do you have any allergies, especially to medications or latex? *

Yes No

What are your fitness goals? *

Submit

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