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Exercise program goals questionnaire
Program goals questionnaire
Please fill out this form, it will help with planning your program.
Date
Name
First
Last
Please write in a few words what your goals are, or why you want you want to undertake a program:
Please list your goals in order of importance, use the (+) sign to add lines:
Please describe how often you plan to exercise (which days, how long you will dedicate on those days):
Please list the sports / activities you currently participate in:
If your sport / activity is seasonal, or follows a competitive calendar schedule, please describe what the approximate timetable for them are (pre-season, in-season, post-season) (important dates: tournaments, races, events, etc.):
Do you have any injury, restriction, or concern that may prevent you from doing any exercise?
Yes
No
Please list them (and provide a little background if necessary):
Injury, restriction, concern:
Describe
What is your past experience with exercise, what have you done in the past?
Where will you be working out (location), and what equipment do you have available?
Is there anything else that may pertain to your exercise routine?
