Personal Fitness Questionnaire

1. What are your fitness/Health goals for the next month? 6 months? 1-2 years?

2. Do you have any health diagnoses that could interfere with regular exercise?

3. Please list all health issues/condition/injuries:

4. Are you exercising currently? If so, what are you doing and how often?

5. Have you tried working with a personal trainer in the past? How was that experience? What worked and what did not?

6. What have been/are barriers to regular exercise?