Personal Training In Columbus, Ohio

Name *

First Name

Last Name

I confirm that the information presented on this form is accurate and answered to the best of my knowledge *

Yes

No

What style of training are you most interested in? *

One-on-one Personal Training

Small-Group Training Sessions

Zoom Sessions

Health history (check if you have a history of any of the following) *

Heart attack

Bypass or Cardia surgery

Chest discomfort

high blood pressure

Rapid or runaway heartbeat

Skipped heartbeat

Rheumatic fever

Shortness of breath

Fainting or lightheadedness

High blood fat (lipid) level

Stroke

Recent hospitalization

Other

Please check if any of these apply to you *

Do you take medications?

Do you have allergies?

Do you smoke?

Do you have any food allergies?

Are you currently involved in an exercise routine? *

Yes

No

Do you have any reason to be cleared by a doctor before partaking in an exercise routine? *

Yes

No

Maybe

I understand that by partaking in an exercise routine I am doing so at my own risk. *

Yes

No

Have you ever worked with a trainer before? *

Yes

No

How did you hear about my services? *

Instagram

Facebook

Website

Friend Referral

Event

Business Card

Other