Personal Training Information Sheet

By providing the information requested below, you will enable your personal trainer to best meet your needs in terms of training goals and time constraints. While your personal trainer will try to meet requests for specific days and times, our ability to do so depends on staff availability and the demand on exercise equipment in the fitness center.

Name:

Age:

E-mail:

Gender: M F

Please list a first, second, and third choice for training times and days:

1.   
2.   
3.   

What are your preferred forms of exercise?
(check all that apply):.

  Walking
  Jogging
  Running
  Treadmill
  Bicycling
  Better quality of life
  Rowing
  Swimming
  Stair climbing
  Cross-country skiing
  Elliptical
  Aqua aerobics
  Land aerobics
  Athletics
  Circuit training
  Free weights
  Other

List your previous history with exercise. Please be as specific as possible by including frequency, duration and years/months of each activity.

Please list your specific training goals below. Try to be as specific as possible (i.e. to attain a desired clothing size or body fat percentage, improve a sport related skill, train for an upcoming race etc). Please include dates or a time frame that you would like to achieve each goal.