GENERAL CLIENT INFORMATION:
(1 being desk job/sedentary and 10 being EXTREMELY active/labor)
(1 being desk EXTREMELY sedentary (sitting all day/no exercise) and 10 being EXTREMELY active (moving all day/daily exercise)
Please answer YES or No to the following questions, unless otherwise stated:
Please complete the following medical questions in full detail.
(1=Unhealthy, 3=Average, 5=Good)
(i.e. Breakfast, Snack, Lunch, Dinner, Snack)
(Keep in mind that two standard water bottles or four glasses of water equals one litre)
Do you have any foods that you refuse to eat due to taste aversion? *
Please CHECK any foods you REFUSE to eat from the list below.
(1=not very, 5=every meal)
HEALTH - PAR-Q FORM
Please answer YES or NO to the following questions, unless otherwise stated:
Please answer NO if your dizziness was associated with over-breathing (including during vigorous exercise)
(i.e. diabetes, osteoporosis, high blood pressure, high cholesterol, arthritis, anorexia, bulimia, anemia, epilepsy, respiratory ailments, back problems, etc.)
DEVELOPING YOUR FITNESS PROGRAM