Health and Fitness Assessment This form ensures we understand your current fitness level, movement ability, and health background before you join. CompanyThis field is for validation purposes and should be left unchanged.Contact InformationName(Required) First Last Email(Required) Enter Email Confirm Email Phone(Required)Age(Required)Physical Activity HistoryHow would you describe your current fitness level?(Required)Please select...Beginner (little to no exercise)Intermediate (some activity but inconsistent)Advanced (regularly active & experienced)What types of exercise have you done before? (Check all that apply)(Required) Group fitness classes Personal training Yoga/Pilates Strength training Cardio (running, cycling, HIIT, etc.) Other Select AllDo you have experience modifying exercises on your own when needed?(Required)Please select...Yes, I can adjust movements based on my abilitySometimes, but I need guidanceNo, I need individual coaching to modify safelyAre you comfortable following verbal and visual instruction in a group setting?(Required)Please select...Yes, I can follow along without difficultySometimes, I struggle to apply cues quicklyNo, I require one-on-one coachingHealth ConsiderationsDo you have any injuries or medical conditions that might affect your ability to exercise safely?(Required)Please select...YesNoPlease explain your injuries and/or medical conditions that might affect your ability to exercise safely.(Required)Do you have any joint replacements?(Required)Please select...YesNoDo you have muscular/tendon/ligament tears or inflammation?(Required)Please select...YesNoDo you have any joint range of motion limitations?(Required)Please select...YesNoDo you have any bone density problems (osteoporosis)?(Required)Please select...YesNoDo you have any spinal fusions or spine movement limitations?(Required)Please select...YesNoAre you currently under medical supervision or have any movement restrictions?(Required)Please select...YesNoGoals & ExpectationsWhat are your primary fitness goals? (Check all that apply)(Required) Improve overall health Lose weight Build strength Increase flexibility/mobility Improve mental health/stress relief Other (please specify) Select AllPlease share your other fitness goals below.What kind of support do you feel you need to be successful in a fitness program?(Required)Please select...Structure & accountability in a group settingPersonalized guidance & detailed instructionA mix of both
