Coach Evaluation Form

Name(required)

Email(required)

Date of Birth(required)

Do you have a preference for a male or female fitness coach?

Personal Habits

Do you currently or have you played sports in the past? If yes, please describe:

Has fitness been an important part of your life in the past? If yes, please describe:

Do you currently exercise? If yes, please describe:

Do you currently follow any dietary restrictions? If yes, please describe:

What are your goals and what do you hope to achieve if you sign up with our team?

Name a famous person, model, or athlete whose fitness level is one you would most like to achieve:

Medical Information

Do you currently suffer from any chronic medical conditions? If yes, please describe:

Have you suffered from any serious medical conditions in the past? If yes, please describe:

Have you had any broken bones and/or surgeries in the past? If yes, please describe:

Are you currently experiencing pain, unusual weaknesses, or problems breathing? If yes, please describe:

DISCLAIMER:

Heights Fitness highly recommends that you discuss any changes to your diet or activity levels with your personal doctor. Heights Fitness assumes you have already discussed these things with your doctor before pursuing any training from our coaches. Heights Fitness takes no responsibility for injuries caused by underlying medical conditions that you have not listed or discussed with us previously. Heights Fitness employs no doctors or medical professionals and is not authorized to provide medical advice. There will be no refunds once you have purchased a training package with any of our coaches. Any unused training sessions will expire 1 year from the date they are purchased

Type your full name here to acknowledge that you have read and agreed to the disclaimer: