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	Do you currently participate in physical activity?* Yes No Please select an option.
	What types of physical activity do you currently participate in?* Please fill this field.
	How often do you participate in these activities?* Please select an option.
	How much time do you spend each week participating in these activities?* Please select an option.
	How would you rate the intensity of your exercise? (scale 1-10)* Please select an option.
	When was the last time you were regularly active?* Please select an option.
	Do you or have you had any injuries, illness or pain that may affect your training ability? If yes, please provide details.* Yes No Please select an option. Please fill this field.
	Are you pregnant? If yes: How many months?* Yes No Please select an option. Please select an option.
	Have you ever been advised by a physician to avoid any type of exercise? If yes, please provide details.* Yes No Please select an option. Please fill this field.
	Do you, or have you ever had, any of the following? Arthritis or rheumatism Asthma, emphysema or bronchitis Stiffness or pain in your neck Backache or Scoliosis Pain in your knees Sore feet Hernia Diabetes Heart disease Any other chronic illnesses High blood pressure Raised cholesterol levels Any other health problems
	Do you take any medication (prescribed or over the counter) regularly? If yes, please provide details.* Yes No Please select an option. Please fill this field.
	Are there any medical issues we should know about?* Yes No Please select an option. Please fill this field.
	What are your fitness goals?* Please fill at least one field. 1. 2. 3.
	Are you training for a specific event? (wedding, triathlon, beach vacation, sports competition) If yes, please provide details on the event and the target date.* Yes No Please select an option. Please fill this field.
	What types of physical activity do you enjoy?* Please fill this field.
	Where will you be training?* Please select an option.
	Please list all equipment you have access to : Please fill this field.
	Would you like us to recommend equipment to you?* Yes No Please select an option.
	What is the maximum number of days per week you are able to train?* Please select an option.
	What is the maximum amount of time you are able to spend in each training session?* Please select an option.

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