Fitness EvaluationPlease fill out this fitness evaluation so that we can better asses your goal and see if we are a good fit for eachother. Step 1 of 3 33% About You and Your StatsName First Last Phone*Email Specific Goals:* Lose weight Build Muscle Shape & Tone Increase Endurance Rehabilitate Lose Inches Increase Strength Reduce Stress Improve Posture Improve Balance Improve quality of life Improve Flexibility Additional Notes Time Frame*Age*Height*BF%Body Fat PercentageGoal BF%Goal Body Fat PercentageBMIBody Mass IndexWeight*Goal Weight* Exercise Habits & GoalsHave you been exercising regularly for the past 6 months?*YesNoDo you have experience with resistance training?*YesNoDo you have experience with cardiovascular training?*YesNoWhat does your current routine consist of? How long have you been thinking about getting in shape?* Why is it important that you change now? (Motivational)* What days and times can you commit to working out?*MondayTuesdayWendsdayThursdayFridaySaturdaySunday Additional InfoDo you smoke or drink occasionally?* Unhealthy nutritional habits (fast food, starbucks, sweets, etc.)* If yes, are these habits that we can commit to change? Do you make all your own financial decisions or do you run it by your significant other?* How many times have you started and stopped a nutrition and or exercise program in the past 10 years*1-56-1011-1516-2021-30In your own opinion why did you fail to “stick with it”?*DisciplineKnowledgeMotivationLack of ResultsProcrastinationOn a scale of 1-10, where are your health and fitness goals at this time?*12345678910Are there any medical conditions that we should be aware of?* MEMBERS ACKNOWLEDGEMENT AND ASSUMPTION OF RISK AND FULL RELEASE FROM LIABILITY OF SHAPE 2 TONE Member acknowledges that the personal training/fitness assessment hereunder includes participation in the strenuous physical activities, including but not limited to, aerobics dance, weight training, stationary bicycling, various aerobic conditioning machines and various nutritional programs offered by SHAPE 2 TONE Member agrees to assume all risk and responsibility involved with participation in the physical activities. Member affirms that member is in good physical condition and does not suffer from any disability that would prevent or limit participation in the physical activities. Member acknowledges that participation will be physically and mentally challenging, and member agrees that it is the responsibility of member to seek competent medical or other professional advice regarding any concerns involved with the ability of member to take part in SHAPE 2 TONE physical activities. Member agrees to assume any and all risks and take responsibility for not exceeding his/her own physical limits.Initials*Date* CommentsThis field is for validation purposes and should be left unchanged.