Personal training health questionnaire template, free on Happier Forms

Your name*

Email*

Phone*

Has a doctor ever said you have a heart condition or high blood pressure?*

NoYes

Do you get chest pain at rest, in daily life, or when you exercise?*

NoYes

In the last 12 months, have you lost your balance from dizziness or passed out?*

NoYes

Has a doctor diagnosed another long-term condition, such as diabetes, asthma or arthritis?*

NoYes

Do you take prescribed medicine for a long-term condition?*

NoYes

Do you have a bone, joint or muscle problem that exercise could make worse?*

NoYes

Has a doctor said you should only exercise with medical supervision?*

NoYes

Do you get unusually out of breath, or leg cramps when walking a short distance?*

NoYes

How active are you now?*

Not very activeSome activity, a few times a week30 minutes or more, at least 3 days a week, for the last 3 months

What are your goals?

Past injuries or surgeries

Personal training health questionnaire