An individualized resistance training program, built-in progressive variance to assure continued results,
    complete with pictures and descriptions of each exercise.

    An individualized resistance training program, built-in progressive variance to assure continued results,
    complete with pictures and descriptions of each exercise.

    • Complete flexibility routine for each major muscle group including pictures and descriptions to improve joint range of motion and assure safety.
    • Cardiovascular training recommendations and guidelines built to meet your needs.
    • A 1-on-1 appointment with your personal trainer for individual exercise description and demonstration to assure proper technique and safety.
    • Continued support and assistance from your personal trainer to increase motivation and improve results

    Your Name (required)

    Your Email (required)

    Member Number (required)

    Telephone Number (required)

    Age (required)

    Gender (required)

    Current Exercise Regimen

    1. On a regular basis, how many days a week do you devote to cardiovascular exercise, strength training, and/or flexibility? Please expand below.
    Cardiovascular:

    Strength:
    Flexibility:

    2. Which of the following cardiovascular exercises/machines have you used? (please check)

    3. Which of the following resistance training methods have you used?

    4. Have you participated in a structured exercise program in the past?

    If you answered YES, how long have you participated?

    5. Do you have any physical limitations that might prevent you from doing resistance or
    cardiovascular training? (Please list any exercises or machines that aggravate existing conditions or those you prefer
    to avoid in your program)

    6. How many days per week and how much time per session do you have to devote to resistance
    training?
    (Please check appropriate days per week and time per session)

    7. How many days per week and how much time per session do you have to devote to cardiovascular
    training?
    (Please check appropriate days per week and time per session)

    8. What benefits do you want to achieve from your exercise program? (Check all that apply)

    9. Are there any specific areas you would like to target in your workout?

    10. If you like to work with a specific personal trainer for your 8-week program please put their name
    here?

    11. Additional Comments: