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Personal Trainer Questionnaire PDF Details

When looking for a personal trainer, it is important to find one that is a good fit for you. To help make your decision, consider using a personal trainer questionnaire form. This will help you to better evaluate the potential trainers and determine which one is right for you. The questionnaire will ask about your fitness level, goals, and preferences. It is important to be truthful when completing the form so that you can get the most accurate information possible. Be sure to ask any questions that you have about the process so that you can make an informed decision.

This figure provides information about personal trainer questionnaire. It's advised that you look at this information before you start editing the form.

Question	Answer
Form Name	Personal Trainer Questionnaire
Form Length	3 pages
Fillable?	Yes
Fillable fields	115
Avg. time to fill out	23 min 49 sec
Other names	personal training consultation questionnaire, personal training forms, personal training questionnaire pdf, trainer questionnaire

12

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Date_____/_____/_____

PERSONAL TRAINING QUESTIONNAIRE

First Name: _________________________________Last Name: __________________________________

Address 1:______________________________________________________________________________

Address 2: _____________________________________________________________________________

City, State, Zip: ________________________________________ Date of Birth: ______/_______/_______

Phone # _______________Email:______________________________________ CWID:__________________

Affiliation: ☐ Undergrad ☐ Graduate/Doctorate ☐ Faculty/Staff ☐ Alumni ☐ Other: _______________

Emergency Contact: _______________________Relationship: _________________ Phone: _______________

1.) Please describe your current and/or previous exercise experience:

2.) How many sessions per week would you like to meet with your trainer? _______

3.) Do you plan to exercise in addition to personal training sessions? If so, how many times per week? ____

4.) Are you currently taking any over-the-counter or prescription medications or drugs? If so, please list:

5.) What are your health and fitness goals? (Check all that apply)

☐ Weight Loss ☐ Cardiovascular Exercise	☐ Muscle Strength and Endurance ☐ Flexibility
☐Other __________________
6.) Do you prefer working with a: ☐ Male Trainer	☐ Female Trainer ☐No Preference

7.) Do you have a specific trainer in mind? ☐ Yes ☐ No If yes, please specify. _______________________

Check		Early	Mid-	Early	Mid-	Early	Late
Preferred		Morning	Morning	Afternoon	Afternoon	Evening	Evening
Times/Days		6-8am	9-11am	12-2pm	3-5pm	6-8pm	9-12am

MONDAY

TUESDAY

WEDNESDAY

THURSDAY

FRIDAY

SATURDAY

SUNDAY

Physical Activity Readiness Questionnaire (American College of Sports Medicine, 1998): Check the appropriate box on each question. A physician’s release will be required if you answer “yes” to any item

listed in the box below.

YES NO

☐	☐	1.	Has your doctor ever said that you have a heart condition and that you should
			only do physical activity recommended by a doctor?
☐	☐	2.	Do you feel pain in your chest when you do physical activity?
☐	☐	3.	In the past month, have you had chest pain when you were not doing
			physical activity?
☐	☐	4.	Do you lose your balance because of dizziness or do you ever lose
			consciousness?
☐	☐	5.	Do you have a bone or joint problem that could be made worse by a change
			in your physical activity?
☐	☐	6.	Is your doctor currently prescribing drugs (for example, water pills) for your
			blood pressure or heart condition?
☐	☐	7.	Do you know of any other reason why you should not do physical activity?

Additional Information: Please mark all that apply.

☐1. Smoke or quit smoking in the last 3 months

☐2. Taking medication for high blood pressure

☐3. Hernia or other condition that may be aggravated by lifting weights

☐4. Diabetes

☐5. Recent surgery (last 12 months) Explain:

☐6. Pregnancy (now or within the last 3 months)

☐7. Pre-existing injuries or physical restrictions that may limit your ability to exercise. If so, please explain:

RELEASE AND INDEMNITY AGREEMENT:

I hereby release the Board of Regents of Oklahoma State University and all its employees from all claims on account of injury which may be sustained while attending this class, and I agree to indemnify the Board of Regents of Oklahoma State University and its employees for any claim which may hereafter be presented as a result of such injuries.

Print Name ________________________________________________________________________________

Signature _______________________________________________________Date______________________

PHYSICIAN’S STATEMENT AND CLEARANCE FORM

At the Department of Wellness, your safety is our primary concern. For this reason, we comply with the health and fitness standards of the American College of Sports Medicine.

On the Physical Activity Readiness Questionnaire (PAR-Q), you identified that you have one or more coronary and/or other medical risk factors which may impair your ability to exercise safely. For this reason, you need to have a physician complete and return this medical clearance form before you can begin exercising at the Seretean Wellness Center or the Colvin Recreation Center.

We recognize that you are eager to start your fitness program, and we sincerely regret any inconvenience that this may cause you. However, please keep in mind that we want your exercise experience to be as safe as possible.

Please ask your physician to complete the bottom portion of this form. He/she may fax the form back to us at the number listed below.

I hereby give my physician permission to release any pertinent medical information from any medical records to the staff at the Department of Wellness. All information will be kept confidential.

Patie t’s a e t pe or pri t __________________________________________DOB _______________

Patie t’s sig ature: ________________________________________________ Date: _______________

Reason for medical clearance _____________________________________________________________

Ph sicia ’s		a	e __________________________________ Pho e _____________ Fa			____________

					FOR PHYSICIAN USE ONLY
Please check one of the following statements:
	I co	cur with		patie	t’s participation with no restrictions
	I co	cur with		patie	t’s participatio i a e ercise progra with the followi	g restrictio s:
	______________________________________________________________________________
	I do not co cur with				patie t’s participation in an exercise program with the
	Department of Wellness.
	Reason________________________________________________________________________
Ph sicia ’s		a	e t pe or pri t		___________________________________________________________
Ph	sicia ’s signature _______________________________________________ Date _______________

Please return to:

Preston Nesemeier, B.S.

Fitness Coordinator

Seretean Wellness Center

Phone: 405-744-2379

Fax: 405-744-7670

How to Edit Personal Trainer Questionnaire Online for Free

Completing the personal training consultation questionnaire form is not hard with our PDF editor. Keep up with these particular steps to prepare the document in no time.

Step 1: Press the orange "Get Form Now" button on the page.

Step 2: Now you can manage your personal training consultation questionnaire. Feel free to use our multifunctional toolbar to add, delete, and alter the content material of the file.

The particular segments will help make up the PDF form:

personal training questionnaire form empty spaces to complete

Remember to fill up the Other, Early, Morning, am Mid, Morning, am Early, Mid, Afternoon, Afternoon, Early, Evening, pm Late, and Evening, am field with the appropriate information.

Filling in personal training questionnaire form part 2

Identify the most vital details of the WEDNESDAY, THURSDAY and FRIDAY, SATURDAY, SUNDAY area.

personal training questionnaire form WEDNESDAYTHURSDAY, and FRIDAYSATURDAYSUNDAY fields to insert

The field is the place to put the rights and responsibilities of either side.

part 4 to entering details in personal training questionnaire form

Look at the sections Diabetes, explain, result, of, such, injuries Print, Name and Signature, Date and next complete them.

step 5 to finishing personal training questionnaire form

Step 3: As soon as you've clicked the Done button, your document is going to be readily available export to any type of electronic device or email address you identify.

Step 4: Just be sure to generate as many duplicates of the file as you can to prevent possible misunderstandings.

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