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When embarking on a fitness journey with the help of a personal trainer, a thorough understanding of your health, goals, and preferences is essential for a successful partnership. The Personal Trainer Questionnaire form serves as a crucial tool for both the individual and the trainer to gather important information that will guide their sessions together. Initially, the form captures basic personal information, including your name, contact details, and date of birth, ensuring that your trainer has a complete view of who you are. The next section explores your exercise history, allowing you to reflect on your current or previous experiences and how many training sessions you would ideally like to have each week. Understanding your health and fitness goals is vital, too; the form includes checkboxes for key objectives, such as weight loss or increased endurance. This helps your trainer tailor your program to meet your specific aspirations. Additionally, the questionnaire addresses any health concerns, asking about current medications and potential medical restrictions. There’s even a space to indicate any preferences regarding the trainer’s gender. Finally, the form includes a Physical Activity Readiness Questionnaire, which ensures you're prepared to start an exercise program safely. Engaging in this comprehensive assessment enables a personalized approach to fitness, paving the way for a successful training experience.

Personal Trainer Questionnaire Example

Date_____/_____/_____

PERSONAL TRAINING QUESTIONNAIRE

First Name: _________________________________Last Name: __________________________________

Address 1:______________________________________________________________________________

Address 2: _____________________________________________________________________________

City, State, Zip: ________________________________________ Date of Birth: ______/_______/_______

Phone # _______________Email:______________________________________ CWID:__________________

Affiliation: ☐ Undergrad ☐ Graduate/Doctorate ☐ Faculty/Staff ☐ Alumni ☐ Other: _______________

Emergency Contact: _______________________Relationship: _________________ Phone: _______________

1.) Please describe your current and/or previous exercise experience:

2.) How many sessions per week would you like to meet with your trainer? _______

3.) Do you plan to exercise in addition to personal training sessions? If so, how many times per week? ____

4.) Are you currently taking any over-the-counter or prescription medications or drugs? If so, please list:

5.) What are your health and fitness goals? (Check all that apply)

☐ Weight Loss ☐ Cardiovascular Exercise

☐ Muscle Strength and Endurance ☐ Flexibility

☐Other __________________

 

6.) Do you prefer working with a: ☐ Male Trainer

☐ Female Trainer ☐No Preference

7.) Do you have a specific trainer in mind? ☐ Yes ☐ No If yes, please specify. _______________________

Check

 

Early

Mid-

Early

Mid-

Early

Late

Preferred

 

Morning

Morning

Afternoon

Afternoon

Evening

Evening

Times/Days

 

6-8am

9-11am

12-2pm

3-5pm

6-8pm

9-12am

 

 

 

 

 

 

 

 

MONDAY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TUESDAY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

WEDNESDAY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

THURSDAY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FRIDAY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SATURDAY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SUNDAY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Physical Activity Readiness Questionnaire (American College of Sports Medicine, 1998): Check the appropriate box on each question. A physician’s release will be required if you answer “yes” to any item

listed in the box below.

YES NO

☐☐ 1. Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?

☐☐ 2. Do you feel pain in your chest when you do physical activity?

☐☐ 3. In the past month, have you had chest pain when you were not doing physical activity?

☐☐ 4. Do you lose your balance because of dizziness or do you ever lose consciousness?

☐☐ 5. Do you have a bone or joint problem that could be made worse by a change in your physical activity?

☐☐ 6. Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition?

☐☐ 7. Do you know of any other reason why you should not do physical activity?

Additional Information: Please mark all that apply.

☐1. Smoke or quit smoking in the last 3 months

☐2. Taking medication for high blood pressure

☐3. Hernia or other condition that may be aggravated by lifting weights

☐4. Diabetes

☐5. Recent surgery (last 12 months) Explain:

☐6. Pregnancy (now or within the last 3 months)

☐7. Pre-existing injuries or physical restrictions that may limit your ability to exercise. If so, please explain:

RELEASE AND INDEMNITY AGREEMENT:

I hereby release the Board of Regents of Oklahoma State University and all its employees from all claims on account of injury which may be sustained while attending this class, and I agree to indemnify the Board of Regents of Oklahoma State University and its employees for any claim which may hereafter be presented as a result of such injuries.

Print Name ________________________________________________________________________________

Signature _______________________________________________________Date______________________

PHYSICIAN’S STATEMENT AND CLEARANCE FORM

At the Department of Wellness, your safety is our primary concern. For this reason, we comply with the health and fitness standards of the American College of Sports Medicine.

On the Physical Activity Readiness Questionnaire (PAR-Q), you identified that you have one or more coronary and/or other medical risk factors which may impair your ability to exercise safely. For this reason, you need to have a physician complete and return this medical clearance form before you can begin exercising at the Seretean Wellness Center or the Colvin Recreation Center.

We recognize that you are eager to start your fitness program, and we sincerely regret any inconvenience that this may cause you. However, please keep in mind that we want your exercise experience to be as safe as possible.

Please ask your physician to complete the bottom portion of this form. He/she may fax the form back to us at the number listed below.

I hereby give my physician permission to release any pertinent medical information from any medical records to the staff at the Department of Wellness. All information will be kept confidential.

Patie t’s a e t pe or pri t __________________________________________DOB _______________

Patie t’s sig ature: ________________________________________________ Date: _______________

Reason for medical clearance _____________________________________________________________

Ph sicia ’s

a

e __________________________________ Pho e _____________ Fa

____________

 

 

 

 

 

 

 

 

 

 

 

 

FOR PHYSICIAN USE ONLY

 

Please check one of the following statements:

 

I co

cur with

patie

t’s participation with no restrictions

 

I co

cur with

patie

t’s participatio i a e ercise progra with the followi

g restrictio s:

 

______________________________________________________________________________

I do not co cur with

patie t’s participation in an exercise program with the

 

 

Department of Wellness.

 

 

Reason________________________________________________________________________

Ph sicia ’s

a

e t pe or pri t

___________________________________________________________

Ph

sicia ’s signature _______________________________________________ Date _______________

Please return to:

Preston Nesemeier, B.S.

Fitness Coordinator

Seretean Wellness Center

Phone: 405-744-2379

Fax: 405-744-7670

Get Personal Trainer Questionnaire PDF Form

Form Characteristics

Fact Name Description
Purpose The Personal Trainer Questionnaire is designed to gather essential health and fitness information from clients to tailor their training experience.
Emergency Contact Users must provide an emergency contact’s name, relationship, and phone number, which helps ensure safety during training sessions.
Health Screening The form includes a Physical Activity Readiness Questionnaire (PAR-Q) to assess any risks associated with exercise, requiring a physician’s clearance if risks are identified.
Filling Out Options Clients specify their preferences for the type of trainer, preferred training times, and the goals they wish to achieve.
Information Confidentiality All information provided in the form is kept confidential to protect clients' privacy.
State-Specific Laws In states like Oklahoma, liability waivers like the one included in the form are governed by the Oklahoma Recreational Use Statute.
Client Goal Identification Clients can select multiple health and fitness goals such as weight loss, muscle strength, or flexibility from the form.
Indemnity Agreement Users agree to release and indemnify the facility from claims of injury, providing an extra layer of protection for both parties.

Guidelines on Utilizing Personal Trainer Questionnaire

Completing the Personal Trainer Questionnaire is a critical step toward beginning your personalized fitness journey. The information you provide will help ensure that you have the best experience possible, tailored to your needs and goals. Here’s how to fill out the form step by step.

  1. Write the date: Fill in the date at the top of the form.
  2. Enter your personal details: Provide your first name, last name, and address. Include your city, state, zip code, date of birth, phone number, email address, and CWID.
  3. Select your affiliation: Check the box that represents your status, whether you're an undergrad, graduate, faculty, staff, alumni, or other.
  4. Fill in emergency contact information: Write down your emergency contact's name, relationship to you, and phone number.
  5. Describe your exercise experience: Provide details about your current or previous workout experiences in the space provided.
  6. Indicate training frequency: Write down how many sessions you would like to meet with your trainer each week.
  7. Plan for additional exercise: If you intend to work out separately from the personal training sessions, note how many times a week you plan to exercise.
  8. List medications: If you are taking any over-the-counter or prescription medications, list them in the designated area.
  9. State your health and fitness goals: Check all relevant boxes that apply to your goals, such as weight loss or cardiovascular exercise, and specify any other goals you may have.
  10. Trainer preference: Indicate whether you prefer to work with a male or female trainer, or if you have no preference.
  11. Specify a trainer: If you have a specific trainer in mind, mark “Yes” and write their name; otherwise, select “No.”
  12. Preferred training times: Check your availability for different times and days of the week.
  13. Complete the Physical Activity Readiness Questionnaire: Check the boxes for each question regarding your health history. A doctor’s clearance is needed if you answer “yes” to any of them.
  14. Additional health information: Mark any applicable health issues that may affect your exercise routine.
  15. Sign the release and indemnity agreement: Print your name, sign, and date the agreement to acknowledge your understanding.
  16. Request physician’s statement and clearance: If required, fill out your name and date of birth, and have your physician complete the necessary information.

Once you have filled out the questionnaire, ensure all sections are complete and accurate. This will not only help personalize your training experience but also ensure your safety during workouts. If you have any further questions, don’t hesitate to reach out to the wellness center staff for assistance.

What You Should Know About This Form

What is the purpose of the Personal Trainer Questionnaire form?

The Personal Trainer Questionnaire form is designed to gather essential information about you and your fitness background. By understanding your current exercise habits, health conditions, and fitness goals, your personal trainer can create a tailored exercise program that fits your individual needs. This ensures your workouts are safe, effective, and aligned with your aspirations.

Who should fill out the Personal Trainer Questionnaire?

Anyone looking to work with a personal trainer should complete this questionnaire. Whether you are a seasoned athlete or a beginner, the form helps trainers understand your unique situation. Additionally, if you have specific health conditions or past injuries, sharing that information upfront is crucial for your safety and the effectiveness of your training.

What kind of information is collected in the form?

The form collects a variety of information, including basic personal details, your exercise history, health status, fitness goals, medication use, and preferences regarding trainer gender and scheduling. This comprehensive approach ensures that all aspects of your health and fitness are considered in planning your training sessions.

What if I answer “yes” to any of the health questions?

If you answer "yes" to any health-related questions, it’s a signal for caution. A physician’s clearance will be required before you can begin exercising. This step is important to ensure your safety. Make sure to consult with your healthcare provider and follow their recommendations for safe participation in physical activities.

How does my choice of trainer affect my experience?

Your choice of trainer can enhance your comfort and motivation levels. Whether you prefer a male or female trainer, the form allows you to express these preferences. A good rapport with your trainer can lead to a more enjoyable and effective workout experience, so choose someone who you feel you can connect with.

Can I specify my preferred training schedule?

Absolutely! The Personal Trainer Questionnaire includes options for you to indicate your preferred days and times for training sessions. Whether you’re an early bird or prefer evening workouts, sharing your availability helps in scheduling sessions that fit seamlessly into your routine.

What should I do if I have a specific trainer in mind?

If you have someone particular in mind, feel free to indicate that in the questionnaire. This allows the training staff to consider your preference when matching you with a trainer, helping you to potentially start building a great training relationship right from the beginning.

Are there any special considerations for individuals with injuries?

Yes, if you have pre-existing injuries or physical limitations, it’s crucial that you mention them on the questionnaire. This information helps your trainer design a safe and effective program tailored to your needs, ensuring that your workouts enhance your recovery rather than aggravate any conditions.

What happens if I don’t return the questionnaire?

If the questionnaire isn’t filled out, it could delay your training commencement. Without this information, it’s difficult for a trainer to understand your needs and goals, which may hinder the customization of your fitness plan. Completing the questionnaire ensures that you can begin your training journey as quickly and safely as possible.

Is my information kept confidential?

Your privacy is paramount. All information collected in the Personal Trainer Questionnaire is treated with utmost confidentiality. Only relevant staff members involved in your training will have access to this information, ensuring your safety and personal data are well-protected.

Common mistakes

Filling out the Personal Trainer Questionnaire can seem straightforward, but many people make mistakes that could delay their training or affect their experience. One common error is leaving out critical personal information, like a current phone number or email address. If you can’t be reached, it complicates communication about your training sessions. Ensure all contact details are correct and up-to-date.

Another frequent oversight happens when describing exercise experience. Some individuals write very little or provide vague answers. This information helps trainers tailor programs to fit each person's needs. Be specific! Share what you have done before, any classes you've attended, or particular exercises you enjoy. Clear insights about your past can set the stage for achieving your fitness goals.

Many also forget to include their health and fitness goals. Whether it's weight loss, building strength, or increasing endurance, identifying your objectives is crucial. Check all that apply on the questionnaire. Having clear goals isn’t just a formality; they guide your trainer in devising a program that works for you. Don't skip this section!

Another mistake people often make is glossing over the medical questions. Some may think these questions are unnecessary or irrelevant, but they are crucial to ensure your safety. If you do have any health issues or are taking medications, be honest about them. Not disclosing important medical information can lead to risks during training sessions, so prioritizing this honesty is vital.

Lastly, when it comes to workout preferences like trainer gender, many people leave it blank or select "no preference" without considering their comfort. Choosing a trainer you feel comfortable with can enhance your training experience. Take a moment to think about what works best for you. Whether it’s a male or female trainer, your comfort level can significantly affect motivation and results.

Documents used along the form

When working with a personal trainer, it’s important to complete the Personal Trainer Questionnaire form. This document helps assess your fitness goals and health history. However, there are other essential forms and documents that accompany this questionnaire. Each one serves a unique purpose in ensuring your safety and enhancing your training experience.

  • Physical Activity Readiness Questionnaire (PAR-Q): This form assesses your readiness to engage in physical activity. It identifies any health conditions that may require a doctor's opinion before starting an exercise regimen.
  • Physician’s Statement and Clearance Form: Required if you have risk factors listed on the PAR-Q. It needs to be completed by your physician to confirm that you are cleared for exercise, ensuring your safety.
  • Release and Indemnity Agreement: This document protects the training facility and its employees from liability. By signing, you acknowledge the risks involved and agree not to hold them accountable for any injuries you might incur during training.
  • Health History Questionnaire: This form gathers detailed information about your past medical history, including surgeries, chronic conditions, and medications. It helps trainers design a safe and effective workout plan.
  • Waiver of Liability: Similar to the Release and Indemnity Agreement, this document releases the training facility from any legal claims related to injuries incurred during workouts.
  • Client Agreement Form: This outlines the terms and conditions of your training sessions. It details responsibilities, cancellation policies, payment methods, and other important guidelines.
  • Fitness Assessment Form: After initial evaluations, this form records your starting fitness levels. Measurements may include body composition, strength, endurance, and flexibility.
  • Progress Tracking Sheet: This document helps track your improvements over time. Trainers use it to document your progress, set new goals, and make necessary adjustments to your personalized program.

Completing these documents along with the Personal Trainer Questionnaire helps trainers better understand your needs and ensures a comprehensive approach to your fitness journey. Being informed about each form assists you in preparing for your training sessions and promotes a safer and more organized experience.

Similar forms

  • Health History Questionnaire: This document gathers information about an individual’s medical background and any current health issues. Both forms emphasize understanding the client's experience and potential health risks before engaging in physical activity.
  • Physical Activity Readiness Questionnaire (PAR-Q): Similar to the Personal Trainer Questionnaire, the PAR-Q is designed to determine a person's readiness for physical activity, focusing on safety and identifying medical concerns.
  • Informed Consent Form: Just like the release and indemnity agreement, this form seeks to inform participants of the risks involved in physical activities and ensures they understand and accept these risks.
  • Medical Clearance Form: This document requires a physician’s approval for individuals with specific medical histories, similar to the medical clearance need in the Personal Trainer Questionnaire.
  • Fitness Assessment: Like the Personal Trainer Questionnaire, this form evaluates current fitness levels and helps trainers tailor workout programs based on individual needs and goals.
  • Client Information Form: This document collects personal data and preferences, aligning with the personal and contact information detailed in the Personal Trainer Questionnaire.
  • Dietary Assessment Questionnaire: This form complements fitness questionnaires by assessing eating habits and nutritional needs, helping trainers understand another aspect of their clients' health.
  • Waiver of Liability: Similar to the release and indemnity agreement, this document protects organizations from legal claims by clients during physical activities.

Dos and Don'ts

When filling out the Personal Trainer Questionnaire form, keep in mind these essential do's and don'ts.

  • Do read each question carefully to understand what is being asked.
  • Do provide honest information about your exercise experience and health history.
  • Do specify any medications or health conditions that may affect your training.
  • Do indicate your preferred trainer type to ensure a comfortable experience.
  • Don't rush through the form; taking your time will lead to more accurate responses.
  • Don't leave questions unanswered, as incomplete forms can delay your training.
  • Don't omit emergency contact details; having this information is crucial for your safety.
  • Don't hesitate to ask questions if you're unclear about any part of the form.

Misconceptions

  • Misconception 1: The Personal Trainer Questionnaire is only for beginners.

    This is not true. The form is designed for individuals of all fitness levels. Whether you are a seasoned athlete or just starting your fitness journey, the questionnaire helps trainers tailor their programs to your unique needs and experiences.

  • Misconception 2: The information provided is only used for personal training sessions.

    While the primary purpose is to inform your training program, the information can also help in emergency situations. For example, sharing health details with a trainer enhances safety during workouts.

  • Misconception 3: Completing the form means you are obligated to a long-term training commitment.

    This misunderstanding can deter individuals from filling out the questionnaire. In reality, it simply helps gauge your interests and preferences, and it does not bind you to any training sessions.

  • Misconception 4: Only current medical conditions are relevant.

    The questionnaire also considers past conditions, injuries, or health issues that could affect your ability to exercise. This helps trainers create safe and effective workout plans.

  • Misconception 5: The Physical Activity Readiness Questionnaire (PAR-Q) is optional.

    This is a common myth. If you answer "yes" to any health-related question, a physician’s clearance is necessary before participating in physical activities. This ensures your safety during workouts.

  • Misconception 6: You cannot request specific trainers based on gender.

    In fact, the form allows for your preferences regarding the trainer’s gender. This aspect is crucial for many individuals who may feel more comfortable working with a trainer of a particular gender.

Key takeaways

Filling out the Personal Trainer Questionnaire form is an essential step in your fitness journey. Here are some key takeaways to keep in mind when completing and utilizing this document:

  • Clarity of Information: Provide comprehensive information about your exercise history and current physical condition. This helps the trainer tailor the program to your needs.
  • Goal Setting: Clearly indicate your health and fitness goals. Whether you aim for weight loss or improved flexibility, specifying your objectives will guide your training sessions effectively.
  • Frequency of Sessions: Reflect on how often you wish to meet with your trainer. Indicating your desired weekly sessions will help them develop a realistic and beneficial plan.
  • Medications and Health Considerations: Be open about any medications or health issues. This information is vital for ensuring that your training is safe and effective.
  • Trainer Preferences: If you have any preferences regarding the gender of your trainer, make sure to mark this on the form. Comfort is crucial for a successful training experience.

Using this form thoughtfully will establish a solid foundation for your personal training experience. Be honest and thorough to maximize the benefits of your program.

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