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681-252-0606
info@tpfgym.com
362 W Burr Blvd, Kearneysville, WV
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Training Questionnaire
Fill out the form below to help us match you with the right trainer and program.
Full Name
This field is required, please enter your name.
Email Address
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We'll never share your email with anyone else.
Phone Number
What day/s would be best to work with a trainer?
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
What time/s of day would be best to work with a trainer?
Early Morning (4am-7am)
Mid Morning (7am-10am)
Late Morning (10am-12pm)
Early Afternoon (12pm-3pm)
Late Afternoon (3pm-5pm)
Evening (5pm-10pm)
How active are you?
Very Active (5+ hours per week)
Moderately Active (3-5 hours per week)
Lightly Active (1-3 hours per week)
Sedentary
How active would you like to be?
Very Active (5+ hours per week)
Moderately Active (3-5 hours per week)
Lightly Active (1-3 hours per week)
Sedentary
What are your goals over the next year?
Weight Loss
Muscle Gain
Bodybuilding or other Competition Prep
Sports Performance Training
Joint Mobility
Eliminating Medications
Hormone Balance
Increased Energy Level
Better Sleep
Other
Do you have any injuries or limitations?
Are there any medications you're currently taking that we should know about and that could impact your workouts?
(Please list medication and reason for taking)
Do you have any of the following?
Heart Disease
Heart Attack
Diabetes
Thyroid - Low or High
High Blood Pressure
Low Blood Pressure
High Cholesterol
Depression/Anxiety
Hormonal Imbalance
None
Other
Does anyone in your immediate family have/had any of the following?
Heart Disease
Heart Attack
Diabetes
Thyroid - Low or High
High Blood Pressure
Low Blood Pressure
High Cholesterol
Depression/Anxiety
Hormonal Imbalance
None
Other
For the ladies, how would you describe your monthly cycle?
Does NOT Apply
Regular
Irregular
Nonexistent
Other
Are you taking any supplements? If so, please list them below.
Do you smoke and/or drink? If so, how often?
Do you have any workout experience?
Nope, teach me everything
A little, but I would still like to learn
Yep, but I hate planning for myself. Just tell me what to do
Other
How much time do you have to work out each week?
None
1-2 hours per week
3-4 hours per week
5-6 hours per week
What is your preference for workout plans?
I'm new to the gym, teach me what to do
Make it quick and easy
Light to Moderate Strength Training
Change it up, I get bored easily
Strength Training - Destroy Me
Cardio and Core
Boot Camp Style
Functional Training and Mobility Work
Sports Specific Training
Other
Do you have a request for a specific Trainer?
Whoever is best for my needs
Kyle
Mindy
Paul
Stefanie
Cassie
Jay
Sandy
Fernando
Any special needs or requests?
Anything else we should know?
Are you ready to get started?
Yes
No
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