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WHY PHYSIQUE
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WHY PHYSIQUE
PRICING
REHABILITATION
CONTACT
OUR APP
Physique Studio | PRE-ACTIVITY QUESTIONNAIRE
15702
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PRE-ACTIVITY QUESTIONNAIRE
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Name
*
Address
*
Phone
*
Email
*
Date of Birth
*
Occupation
*
Company
*
Have you ever been to a fitness centre before?
Yes
No
If Yes, when?
What results do you want to achieve?
Reduct body fat
Strength training
Increased endurance
Sports conditioning
Increased energy levels
Reshaping
Rehabilitation
Improved muscle tone
Stress management
Increased fitness
Bodybuilding
Improve self esteem
Other
When would you like to achieve these results
How long have you been thinking about it?
On a scale of 1-10, how important is it that you achieve these results
How many visits per week will you make to achieve these results?
What time of day will you train?
Does your job involved physical activity?
Yes
No
Do you smoke?
Yes
No
Are you pregnant?
Yes
No
How many meals do you eat a day?
How much water do you drink?
Have you ever had:
Heart trouble/history
Epilepsy
Back problems
Faint or dizzy spells
Pain in the chest
Sports injury
Arthiritis
High blood pressure
Bone or joint problems
Asthma
Other