Personal Training Assessment Form

1. Client Information

Full Name

Date of Birth

Contact Number

Email

Emergency Contact (Name & Number)

2. Medical History

Chronic Illness (Yes/No)
YesNo

Injuries/Surgeries (Details)

Medications

Doctor Advised Against Exercise (Yes/No)
YesNo

3. Lifestyle & Habits

Occupation
SedentaryActiveVery Active

Smoking
YesNo

Alcohol
YesNo

Sleep Hours

Stress Level
LowModerateHigh

4. Fitness Background

Activity Level
BeginnerIntermediateAdvanced

Weekly Exercise Frequency

Previous Training Experience

5. Goals

Weight LossMuscle GainStrength BuildingEndurance/StaminaFlexibility & MobilityGeneral Fitness / Lifestyle

Specific Goals

6. Body Measurements

Height (cm)

Weight (kg)

BMI

Body Fat %

Waist (cm)

Hips (cm)

Chest (cm)

Arms (cm)

Thighs (cm)

7. Fitness Tests (Optional)

Resting Heart Rate (bpm)

Blood Pressure

1-Min Push-Ups

1-Min Sit-Ups

Plank Hold (sec)

Flexibility (Sit & Reach cm)

8. Trainer’s Notes & Recommendations

9. Client Consent

I confirm that the above information is accurate. I understand that exercise carries risks and I will inform my trainer of any changes in my health condition.
I Agree

Client Signature

Date

Trainer Signature

Date