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Client Fitness and Health Screening Survey
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1.
What is your name, email and age?
(Required.)
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2.
What is your primary fitness goal?
(Required.)
Weight loss
Muscle gain
Improve endurance
Increase flexibility
General fitness
Fitness event
Other (please specify)
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3.
How would you describe your current fitness level?
(Required.)
Beginner
Intermediate
Advanced
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4.
What types of physical activities do you currently engage in? Select all that apply.
(Required.)
Running
Walking
Cycling
Swimming
Strength training
Yoga/Pilates
Sports
None
Other (please specify)
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5.
How often do you exercise per week?
(Required.)
Less than once
1-2 times
3-4 times
5 or more times
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6.
What is your primary dietary goal?
(Required.)
Weight loss
Muscle gain
Maintain current weight
Improve nutrition
Other (please specify)
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7.
Do you follow any specific dietary plans or restrictions? Select all that apply.
(Required.)
Vegetarian
Vegan
Gluten-free
Keto
Paleo
None
Other (please specify)
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8.
How would you rate your current dietary habits?
(Required.)
Poor
Fair
Good
Very good
Excellent
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9.
Do you have any medical conditions or injuries that affect your ability to exercise?
(Required.)
Yes
No
10.
If yes, please specify the conditions or injuries.