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Personal Training Questionnaire
It is crucial to know certain information about a client before you begin to personal training services. The following questionnaire template will give you a starting point to create a custom survey about the personal and medical information you need in order to get the best results for your client.

Free Sample Template
Format: Word PDF
# of Pages: 3
Printable: Yes


Personal Training Questionnaire TemplateForm 2998
Format: Word PDF
Category: Occupation, Personal Training
Type: Questionaire

Personal Training Questionnaire

Thank you for filling out this personal training questionnaire. All of the information that you provided on this form will be treated as strictly confidential. This personal training information is essential to helping your personal trainer to develop a physical fitness program that directly addresses your needs, goals and interests that is safe and effective. We appreciate your business and if there is any questions that you may have please let us know.

Name: ________________________________________________________________________________________

Address: ______________________________________________________________________________________

City: __________________________________________ State: __________ Zip Code: _______________________

Phone Number: ________________________________________________________________________________

Email Address: _________________________________________________________________________________

Date of Birth: ___/___/_____ Age: _________ Occupation: _____________________________________________

Doctor’s Name: ________________________________________________________________________________

Doctor’s Phone Number: _________________________________________________________________________

Doctor’s Address: _______________________________________________________________________________

City: __________________________________________ State: __________ Zip Code: _______________________

Why did you decide to invest in a Personal Training program? ___________________________________________

_____________________________________________________________________________________________

___ Lose Weight ___ Develop Muscle Tone ___ Nutrition Info ___ Start an Exercise Program ___ Injury Recovery

How did you hear about our Personal Training program? _______________________________________________

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Why did you choose to train with us instead of another personal trainer? __________________________________

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What would cause you to stop training with us? ______________________________________________________

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At what point were you in the best shape of your life? _________________________________________________

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Has exercise been consistent for the past three months? ___ Yes ___ No

When did you first start considering getting back into shape? ___________________________________________

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What has stopped you in the past from participating in a personal training program? ________________________

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On a scale between (1 = low and 10 = high), how would you rate your current level of fitness? _________________

On a scale between (1 = low and 10 = high), how would you rate your current level of nutrition?________________

How many times a day do you usually eat? __________________________________________________________

Do you find yourself skipping meals? ___ Yes ___ No

Do you eat late at night? ___ Yes ___ No

How many glasses of water do you drink per day? _____________________________________________________

Do you ever feel drops to your energy level throughout the day? _________________________________________

How many times per week do you eat out? __________________________________________________________

Do you do your own grocery shopping? ___ Yes ___ No

Do you do your own cooking? ___ Yes ___ No

Besides hunger, why else do you find yourself eating? _________________________________________________

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Do you find that you eat past the point of fullness? ____________________________________________________

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Do you find yourself eating foods that are high in fat and sugar? _________________________________________

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Please list three areas of your nutrition that you would like to improve on: _________________________________

_____________________________________________________________________________________________

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How often do you participate in physical exercise per week? ____________________________________________

If you would like to exercise more often, please list the reasons you are not? _______________________________

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What physical activities are you currently involved with? _______________________________________________

_____________________________________________________________________________________________

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How do you prefer to exercise? Please circle all that apply.

Inside

Outside

Combination

Large groups

Small groups

Alone

Morning

Afternoon

Evening

Home

Gym

What are the days of the week that you would like to commit to a personal training program? Please list time intervals you are available.

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

List in order of priority your fitness goals that you would like to achieve in the next four to twelve months?

1. ______________________________________________________________________________________

2. ______________________________________________________________________________________

3. ______________________________________________________________________________________