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Training Data:
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Name
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First
Last
Email
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Date of Birth/ Age
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Height
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Weight
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Body Mass (if known)
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How many days per week can you Train?
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How many hours per session can you train?
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Are you training now?
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What other physical activities are you doing?
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Do you have a gym membership? Where?
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Describe your work/family schedule and how it will fit with training.
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What are you training goals?
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Health History Data:
Do you smoke? If so, how much?
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Has your doctor cleared you for physical activity?
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Approximate date of last exam?
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Have you had any of the following:
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heart problems
diabetes
high cholesterol
high blood pressure
Are you overweight?
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Do you have any orthopedic problems?
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Do you have an other medical conditions?
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Describe your current exercise program.
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What are the new goals with a coach?
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Consent:
I acknowledge, to the best of my ability, that I am in good health and have no known medical problems that would restrict my ability to participate in this exercise program. (name/date)
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