Camp 1 Fitness · Personal Training

Personal Training Intake

Please complete this before your first session. It helps us understand your goals, screen for anything your trainer should know, and pair you with the right coach.

1. Client information

Full name *

Date of birth *

Phone *

Email *

Emergency contact name *

Emergency contact phone *

If other, please specify

2. Goals & motivation

3. Training history & lifestyle

4. Health screening

Has a doctor ever said you have a heart condition or high blood pressure? *

Yes No

Do you feel pain in your chest at rest, during daily activities, or when you exercise? *

Yes No

Do you lose balance from dizziness, or have you lost consciousness in the last 12 months? *

Yes No

Have you been diagnosed with any other chronic medical condition (other than heart disease or high blood pressure)? *

Yes No

Are you currently taking prescribed medication for a chronic medical condition? *

Yes No

Do you have a bone, joint, or soft-tissue problem that could get worse with physical activity? *

Yes No

Has a doctor ever said you should only do medically supervised physical activity? *

Yes No

Are you currently pregnant or have you given birth in the last 12 months? *

Yes No

Details

Answered Yes to any question? Please give details: injuries, surgeries, areas of pain, medications, or anything else your trainer should know. We may ask for clearance from your healthcare provider.

5. Trainer matching preferences

Preferred format

1:1 private Partner (2 people) Small group Virtual

Sessions per week

1 2 3 4+

Session length

30 min 45 min 60 min

Trainer gender preference

No preference Female Male

Preferred location / studio

Anything else that would help us find the right trainer for you?

6. Client acknowledgment

I confirm the information above is accurate and complete to the best of my knowledge. I will tell my trainer about any changes to my health, and I understand that I should stop exercising and notify my trainer if I feel pain, dizziness, or discomfort. I understand that participation in physical activity carries some risk of injury.

I have read and agree to the statement above. *

Type your full name as your signature *

Date *

Intake received

Thanks for completing your intake. Our team will review it and reach out to pair you with the right trainer. Questions? Call 530-214-8992.

	Early AM5–8 am	Morning8–11 am	Midday11 am–2 pm	Afternoon2–5 pm	Evening5–8 pm
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

Intake received

CAMP 1 Fitness