Section 1: Basic Information

First Name

Last Name

Phone *

Email *

Age *

Apartment Community *

Preferred Contact Method

Section 2: Health & Safety

Do you have any injuries, medical conditions, or physical limitations we should know about?

Have you had any surgeries or major injuries in the past 2 years? *

Yes

If yes: please explain (Have you had any surgeries or major injuries in the past 2 years?) *

Do you currently experience pain during exercise or movement? *

Yes

Are you currently cleared for exercise by your doctor? *

Yes

Not Sure

Are you taking any medications that may affect physical activity? *

Yes

Section 3: Fitness Goals

What would success look like for you in the next 3 months? *

Section 4: Exercise History

How would you describe your current fitness level? *

Beginner

Somewhat active

Regularly active

Very active

How often do you currently exercise? *

I do not currently exercise

1–2 days per week

3–4 days per week

5+ days per week

Have you worked with a personal trainer before? *

Yes

Section 5: Lifestyle

How active are you during a normal day? *

Mostly sitting

Moderately active

Very active

How many hours of sleep do you average per night? *

Less than 5

5–6

7–8

Preferred time to exercise *

Morning

Midday

Evening

Section 6: Nutrition Habits

How would you describe your eating habits? *

Very healthy

Mostly healthy

Balanced but inconsistent

Needs improvement

Would you like nutrition guidance from a trainer? *

Yes

Maybe

Section 7: ResidentFit Programs

What would make this fitness program a great experience for you?

Would you participate in ResidentFit community fitness events or challenges? *

Yes

Address

Street Address

City

State

Country

Postal Code

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