Please complete this questionnaire before your first session. Your answers help your trainer build a program that is safe, effective, and personalised specifically to you. All information is kept strictly confidential.
PAR-Q health screeningLifestyle assessmentGoals & preferencesLiability waiver
1
Personal informationRequired›
Full name
Date of birth
Email address
Phone number
Emergency contact name
Emergency contact phone
Occupation / what does a typical workday look like physically?
2
Health & medical screening (PAR-Q)Required›
The PAR-Q (Physical Activity Readiness Questionnaire) is the industry-standard screening tool to confirm it is safe for you to begin an exercise program. If you answer Yes to any question, please consult your doctor before starting training. All information is strictly confidential.
Additional medical questions
ADo you have or have you ever had any diagnosed medical conditions? If yes, please describe.
BHave you suffered any injuries, past or present? If yes, please explain.
CHave you ever had physical therapy? If yes, what for?
DAre you currently taking any medications? If yes, please list them and any relevant side effects.
EAre you currently under regular care of a doctor for any condition?
FAre you pregnant, or have you given birth in the last 6 months?
GHave you had any surgery in the past 12 months? If yes, please explain.
3
Lifestyle & daily habits›
1How would you describe your current level of physical activity?
2How many hours of sleep do you typically get per night?
3How much water do you drink per day on average?
4How would you rate your typical stress levels? (1 = very low, 10 = very high)
LowHigh
5Describe your typical daily nutrition. What does a normal eating day look like for you?
6Do you smoke or consume alcohol?
4
Fitness goals & preferences›
1What are your primary fitness goals? (select all that apply)
2Why is this goal important to you? What is your deeper motivation?
3Have you previously tried to reach this goal? What worked, and what didn't?
4Have you worked with a personal trainer before?
5What types of exercise do you enjoy or are curious to try? (select all that apply)
6How do you feel about strength and weight training? Any concerns or preconceptions?
7How do you feel about training in a gym environment?
8What fitness equipment do you have access to outside of our sessions?
Your ideal program
How many days per week can you commit to training?
How long would each session ideally be?
What time of day suits you best?
Cardio vs strength preference
9What does your ideal trainer look like? What coaching style works best for you?
10Are there any obstacles, habits, or commitments that could slow your progress?
5
Liability waiver & consentRequired›
Informed consent & liability waiver
I, the undersigned, acknowledge that participation in personal training sessions involves physical exercise and carries inherent risks, including the possibility of injury or adverse medical events. I confirm that I have answered this health screening questionnaire honestly and, to the best of my knowledge, I am physically capable of participating in the proposed exercise program.
I understand that my personal trainer is not a medical professional. I agree to consult my doctor before beginning exercise if I have any health concerns, and to inform my trainer immediately of any changes to my health, fitness level, or medication status that may affect my ability to train safely.
I voluntarily choose to participate in personal training sessions and assume all risks associated with participation. I release my personal trainer from liability for any injury or illness arising from my participation, provided the trainer has not acted with gross negligence or wilful misconduct.
I consent to my health and fitness data being collected and stored securely for the sole purpose of delivering personal training services, in accordance with applicable data protection laws.
Note: If you answered Yes to any PAR-Q question, please obtain written medical clearance from your doctor before your first session.
Photography & video consent
Full name (print)
Date
Signature — type your full name as your electronic signature