RJS Fitness Hermosa Beach Personal Trainer & Nutritionist Free Assessment

1. What are you currently doing for exercise?

2. What does eating healthy mean to you?

3. List all injuries you have ever had and what you did to heal?

4. Do you have any pain?
(once a week back annoyance counts, as does neck pain when your stressed)
Yes (Please specify type of pain)

No

5. What are your top 3 goals? (Relating to Health, Fitness, Nutrition)
1.
2 
3.

6. What problems have you had in the past that prevented you from achieving your goals?

7. How many times per week do you exercise? 0 1 2 3 4 5 6 7+

8. Have you been working out consistently?
Yes    No

(If No, please explain Why)

9. What do you think will be different this time?

10. What are you most interested in?
Nutrition     Supplementation     Core Training
Flexibility Training    Cardio Weight Lifting
Whatever my Personal Trainer recommends
Other

11. What would you like the personal trainer to do for you?