Treasure Life Fitness and Health New Client Form

On this questionnaire, a number of questions regarding your physical health are to be answered. Please answer every question as accurately as possible so that a correct assessment can be made. Please place a check in the space to the left of the question to answer "Yes." Leave blank if your answer is "No." Please ask if you have any questions. Your responses will be treated in a confidential manner.
On this questionnaire, we present a number of questions regarding your history of exercise and your personal preferences. This information will help us create a personalized workout plan for you.
For each activity in which you participate, indicate your typical exercise in minutes:
This questionnaire will help us to understand your personal fitness goals. It is also a "contract" in which we ask you to make a commitment to three concrete steps towards fitness and health. It is not a legal contract with us but rather a personal contract that you make with yourself and with others concerned with your health. Should you have any questions, feel free to ask. Your responses will be treated in a confidential manner. Please indicate your personal health and fitness-related goals:

** Treasure Life Fitness and Health, LLC  d/b/a Treasure Life Fitness and Health shares general nutritional advice based on their knowledge and experience. The owner (member) of Treasure Life Fitness and Health, LLC d/b/a Treasure Life Fitness and Health is not a certified nutritionist or registered dietician. Any advice that you take will be at your discretion.**

 

**The information provided is for educational purposes only. No medical advice is being given. This information has not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease.**

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