[ep_fitness_price_table]

    Full name

    Email

    Phone Number

    Date of Birth

    Gender

    Height

    Weight

    Tshirt size

    Whats the activity level at your job?

    Do you follow a regular working schedule, do you work days, afternoon or nights?

    How often do you travel?

    Please list the physical activities that you participate in outside of the gym and outside of work.:

    If you have any diagnosed health problems list the condition(s).

    If you are on any medications, please list them.

    What additional therapies are being undertaken for the given health problem(s)?

    If you have any injuries, please list them.

    What additional therapies are being undertaken for the given injury?

    Are you experiencing any stresses or motivational problems?

    Has anyone of your immediate family developed heart disease before the age of 60?

    Do any diseases run in your family?

    Do you suffer from diabetes, asthma, high or low blood pressure?

    If yes please list:

    Have you been in army?

    Are you a current cigarette smoker?

    Your current diet could be best characterized as:

    Please rate your readiness for change

    What following goals does best fit in with your goals?

    What is your goal with your training?

    Why?

    Please rate your motivational level to do what it takes for reach your goal.

    Are you currently excersising regulary (at least 3x per week)?

    If yes what kind of training do you do:

    Does it motivate you to challenge your team mates more or to work as a team

    Does it motivate you to have a healthy competition with your teammates more or to work as a team

    Name 5 factors that keep you motivated ?

    5 Obstacles that unmotivate you ?

    Which days do you prefer?

    What timing can work for you


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