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Maui Strong Moms
Exercise History Questionnaire
Name:
Birthday:
Today’s Date:
Address:
Phone:
Email:
Contact In Case of Emergency:
Current Weight:
How long have you been at this weight?
Height:
Have you ever had a personal trainer before?
What did you like most about working with them?
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What did you like least about working with them?
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Describe what you would like to accomplish through your fitness program with me:
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Aside from technical knowledge and personal attention, what type of motivation do you require and expect from a trainer?
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What can we do together to make your exercise routine with me more enjoyable?
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Do you own any type of exercise equipment? (please list)
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What are your current leisure activities?
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