Personal Trainer Questionnaire PDF Details

Filling out a Personal Trainer Questionnaire form marks the beginning of a tailored fitness journey, ensuring that personal trainers can design a workout regimen that aligns perfectly with the unique goals, medical history, and preferences of their clients. By capturing essential details—ranging from basic contact information, exercise experience, fitness objectives, to scheduling preferences—the form facilitates a comprehensive understanding of an individual's current health status and desired outcomes. It also includes critical health and safety components, such as the Physical Activity Readiness Questionnaire (PAR-Q) by the American College of Sports Medicine, and a section for medical clearance, emphasizing the importance of safety and personal well-being in the pursuit of fitness goals. The inclusion of an emergency contact, preferences for trainer gender, and any medications or health conditions, underscores the personalized and client-centered approach to fitness planning. The form culminates with a release and indemnity agreement, underscoring the commitment to safety and responsibility. This detailed approach ensures that both the trainer and client embark on the fitness journey with a clear understanding of the goals, potential risks, and the necessary precautions to be taken, paving the way for a successful and rewarding partnership.

Form NamePersonal Trainer Questionnaire
Form Length3 pages
Fillable fields0
Avg. time to fill out45 sec
Other namespersonal training forms pdf, personal training questionnaire doc, personal training questionnaire form, worry questionnaire pdf

Form Preview Example



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. _______________________

















































































































































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.


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:


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______________________


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


e __________________________________ Pho e _____________ Fa
















Please check one of the following statements:


I co

cur with


t’s participation with no restrictions


I co

cur with


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.




Ph sicia ’s


e t pe or pri t



sicia ’s signature _______________________________________________ Date _______________

Please return to:

Preston Nesemeier, B.S.

Fitness Coordinator

Seretean Wellness Center

Phone: 405-744-2379

Fax: 405-744-7670

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personal training packages pdf empty spaces to complete

Remember to fill up the Do you plan to exercise in, Are you currently taking any, What are your health and fitness, Weight Loss Cardiovascular, Other, Do you prefer working with a, Do you have a specific trainer in, Early Morning am, Mid Morning am, Early Afternoon pm, Mid Afternoon pm, Early Evening pm, Late Evening am, and Check Preferred TimesDays MONDAY field with the appropriate information.

Filling in personal training packages pdf part 2

Identify the most vital details of the Check Preferred TimesDays MONDAY, and WEDNESDAY THURSDAY FRIDAY SATURDAY area.

personal training packages pdf Check Preferred TimesDays MONDAY, and WEDNESDAY THURSDAY FRIDAY SATURDAY fields to insert

The Has your doctor ever said that, Do you feel pain in your chest, In the past month have you had, Do you lose your balance because, only do physical activity, Is your doctor currently, Do you know of any other reason, Do you have a bone or joint, Additional Information Please mark, Smoke or quit smoking in the, and Diabetes field is the place to put the rights and responsibilities of either side.

part 4 to entering details in personal training packages pdf

Look at the sections Pregnancy now or within the last, explain, RELEASE AND INDEMNITY AGREEMENT I, Print Name, Signature Date, and PHYSICIANS STATEMENT AND CLEARANCE and next complete them.

step 5 to finishing personal training packages pdf

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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