Doerz Fitness Assessment

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You may be asking yourself, with so many services available, where do I begin? Doerz
Fitness Assessment appointment is a great start. Your Doerz Trainer is dedicated
to providing appropriate recommendations by reviewing your health and fitness
questionnaire and performing various assessments and measurements.

The recommendations will be based on your individual needs to help you successfully
reach your short and long-term fitness goals.

Your post-assessment consultation with a Doerz Trainer can be delivered by phone or video conference and may consist of the following:

Review of Physical Activity Readiness Questionnaire (PAR-Q)

Review of Health and Lifestyle Questionnaire

Physical assessment and results review

Review of personal fitness goals

Evaluation of aerobic fitness level

Recommendations and program planning

Some members prefer to have a
coach/personal trainer help them achieve success; some prefer our group fitness or
sports programs, while others prefer to try it on their own.

Your Doerz Trainer will make sure you get started in the right direction!
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How did you hear about us?
Facebook
Instagram
Referral
Google
Website
Other
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Have you ever worked out with a Personal Trainer? * This field is required.
YESNO
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Your Full Name* This field is required.
First Name
Last Name
5
Phone Number* This field is required.
Area Code
Phone Number
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Email* This field is required.
example@example.com
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Gender
Male
Female
Decline to Answer
Other
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Height* This field is required.
Feet & Inhes
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Weight* This field is required.Approximate if exact weight is unknown
Lbs
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On a scale of 1 to 10 what is your fitness level (10 being the fittest)* This field is required.
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If you have any diagnosed health problems list the condition (high blood pressure, type 2 diabetes etc)
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Do you currently have an injury, a movement limitation, or pain that limits your ability to exercise? (Knees, Back etc)
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Are you taking any medications or drugs? If yes, please list medication, dose, and reason.
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What are your primary fitness goals?* This field is required.
Reduce body-fat & weight loss
Improve cardiovascular fitness
Reshape or tone body
Strengthen body
Build muscle
Improve sport specific performance
Increase energy level
Improve flexibility and mobility
Improve self-confidence
Feel better, positive attitude
Maintain my workout consistency
Exercise safely and with proper form
Other
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Why haven’t you achieved your goals already? What’s blocking you?
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How many times a week can you commit to training?* This field is required.Type a number
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Why haven’t you achieved your goals already? What’s blocking you?
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How often are you willing to train per week to reach your goal?
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Give us 2-3 body parts you specifically want to focus on?
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Does your significant other or a close friend/family member support your efforts in achieving your personal fitness goals? Skip if this does not apply
YESNO
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How many hours of sleep do you get on average?
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Does your occupation require much activity (i.e. walking, getting up and down, carrying things)?
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What are the things that we can help you out with in order to make sure that you are successful?
Accountability
Nutrition accountability
Structure
Challenge
Variety
Other
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How many meals are you eating daily?
1
2
3
4
5
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How many times per day are you currently eating out?
1
2
3
4
None
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Do you have any food allergies, sensitivities, or preferences?* This field is required.
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On a scale of 1 to 10 (10 being the most serious) How serious are you about accomplishing your fitness goals?* This field is required.
Should be Empty: