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SAN ANTONIO TEXAS

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Want to learn how to lose body fat?

Take the fitness quiz below and click submit. You'll be prompted to schedule your first lesson on how to lose body fat.

Fitness Quiz

First Name

Last Name

Email

Phone

Birthday

Address

Weight

Height

Have you ever been a member at another health club? *

Yes

No

If Yes, how long did you keep your last health club membership while not using the facility?

What did you like about it?

What were your dislikes about the facility?

Have you been exercising regularly for the past 6 months?

If Yes, what activies have you been participating in to achieve your goals?

Have you ever used a personal trainer before? *

Yes

No

If Yes, What did you like about it?

What did you dislike about it?

In terms of my health and fitness, I would like to:

Lose Weight

Gain Weight

Look Better

Feel Better

What specific areas would you like to target for improvement?

Arms

Legs

Back

Hips

Waist

Butt

Is there something happening in life that you want to look or feel particulary good for? (For example, a vacation or wedding coming up)

What is motivating you to start a fitness program? (Please be specific in how you are feeling right now and what is making you want to start)

How long have you been thinking about getting back into a regular fitness program? *

Weeks

Months

Years

Over the past 10 years, how many times have you started and stopped a regular fitness program? *

1-5

10-20

Too Many To Count

What external factors have derailed your progress in the past?

I don't make time for it

I don't invest money into my health

I procrastinate when it comes to exercise

I need more support

In your own opinion, why did you fail to "stick with it"?

I lack the discipline to be consistent with exercise and make healthy food choices

i lack the knowledge to know what diet and exercises work for me

I need help with accountabilty in terms of my attendence at the gym and my calorie intake

My training times are 10:00 AM - 10:00 PM Monday - Thursday. What days are you willing t o commit to exercising in order to reach your goal?

Monday

Tuesday

Wednesday

Thursday

My training times are 10:00 AM - 10:00 PM Monday - Thursday. What time frames are you willing t o commit to exercising in order to reach your goal?

10 AM to Noon

Noon to 3 PM

3 PM to 6 PM

6 PM to 10 PM

Do you have any poor health habits you would like to change?

How many packs of cigarettes do you smoke in a week? *

1

2

3

None

How many times do you eat fast food in a week? *

1 time a week

2 times a week

3 times a week

Every Day

What is your ideal weight?

What is your ideal pant size?

what pant size are you now?

how do you feel now at this size?

If you were able to get to your ideal pant size and weight with the help of a personal trainer, how would that make you feel?

on a scale of 1-10 how serious are you about achieving your fitness goal?

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