PHYSICAL READINESS QUESTIONNAIRE

All information received on this questionnaire will be treated as strictly confidential. This information is essential to helping our trainers develop a program that addresses your needs and goals in a safe and effective manner.
Best way to reach you
Have you ever used a personal trainer before?
Have you ever been a member of a health club?
Have you been exercising regularly for the past 6 months?
Do you smoke?
Do you drink?
Over the past 5 years, how may times have you started and stopped a nutrition and/or exercise regimen?
What external factors have derailed your progress in the past?
In your opinion, why did you fail to "stick with it?""
I would like to:
On a scale of 1-5, how serious are you about achieving your goals? *Mehh. I don't want to put too much into itI'm willing to tryI really want toI'm pretty seriousMy motivation is through the roof! Let's Go!On a scale of 1-5, how serious are you about achieving your goals? *

I, the undersigned, do hereby acknowledge that use of Athletic Spa’s services, equipment, or premises involves risk of injury to my person and my property, and that as a condition to use, I assume full responsibility for such risks. I hereby release and hold harmless Athletic Spa, its agents, related entities and employees, from all liability to me, my heirs and assigns for any loss or damage to me, and forever give up any claims therefore on account of injury to my person or property whether caused by the active or passive negligence of Athletic Spa.

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