""
1


Health Questionnaire
First name
Surname
Date of Birth
Address
0 /
Postcode
0 /
Tel:
0 /
Please read the questions below and answer each one carefully, ticking the appropriate box or adding information if necessary. Your response will be kept in the strictest of confidence.
Question Number
YesNo
1) Has your doctor ever said that you have a heart problem?
2) Have you ever had any chest pain when you were doing any activity?
3) Have you ever experienced any chest pain when you were resting?
4) Are you currently taking medication for a heart condition?
5) Are you currently taking medication for any other problems?
6) Do you suffer from bone or joint problems?
7) Have you had any major illness or major surgery?
8) Have you ever been diagnosed with diabetes?
9) Have you ever been diagnosed with epilepsy?
10) Have you ever been diagnosed with asthma?
11) Have you ever been diagnosed with any other health problems?
12) Are you pregnant?
13) Have you recently had a baby?
14) Do you ever lose your balance because of dizziness or lose consciousness?
15) Are you feeling unwell at present due to cold, flu or headache etc?
If you have answered YES to any of the questions above, please enter the question number and a brief description of the medication and condition below.
Question Number & Further DetailsMedication/Condition/Details
0 /
In the interests of your own health & wellbeing we may request that you consult with your doctor to help us establish your starting point of exercise. All personal information provided will be treated in the strictest of confidence.
IF YOUR HEALTH CHANGES SO THAT YOU MAY THEN ANSWER ‘YES’ TO ANY OF THESE QUESTIONS, YOU MUST INFORM A MEMBER OF STAFF AS SOON AS POSSIBLE.
Do you currently exercise?pick one!
During exercise are you able to hold a conversation?pick one!
What is your main goal?
0 /
What else would you like to get out of your PT?
0 /
Please state preferred time / dates for your PT
1st choice
Time
0 /
2nd
Time
0 /
3rd
Time
0 /
tfd ifestyle PT - Agreement, Terms and conditions.

Personal Training Agreement

Congratulations on your decision to get started with a new exercise routine with tfd lifestyle PT. With the help of your personal trainer, you will greatly improve your ability to accomplish your training goals faster,safer and with maximum benefits.

In order to maximise progress, it will be necessary for you to follow program guidelines throughout your supervised personal training sessions. Please remember exercise and healthy eating habits are equally important and we can advise on this aspect too.

However, with any exercise program, there are risks, including increased heart stress and the chance of musculoskeletal injuries. By purchasing and agreeing to personal training with tfd lifestyle PT, you agree to assume full responsibility. You also agree that, to your knowledge, you have no limiting physical conditions or disability that would preclude an exercise program.


Terms and Conditions
  1. Personal training sessions that are not re-scheduled or cancelled 24 hours in advance will result inforfeiture of the session and a loss of the financial investment at the rate of one session.
  2. Clients not available to start the session at the agreed time will receive the remaining scheduled time, unless other arrangements have been previously made with the tfd lifestyle PT.
  3. The expiration policy requires completion of all personal training sessions purchased as follows:
    a. When five sessions are purchased, these will expire 5 weeks after the date of the first booked session in that bundle.
    b. When ten sessions are purchased, these will expire 10 weeks after the date of the first booked session in that bundle.
  4. No refunds will be issued for any reason.
  5. Our services will be withdrawn at the sole discretion of tfd lifestyle PT should any client engage in unreasonable behaviour likely to offend or harm our Personal Trainers. If at any time a tfd LifeStyle PT feels that their personal safety and or well being is at risk, they are instructed to cease all services and report immediately to the management of the tfd lifestyle PT.

Declaration:
Date
Previous
Next