Personal Information
|
 |
Yes
NO
|
1
2
3
4
5
6
7
8
9
10 |
Active
Sedentary |
Yes
NO |
Anniversary
Birthday
Wedding
Vacation
Reunion
Other
|
Time
Lack of Motivation
No Custom Workout Programs
Lack of Quick Results
Other |
1-2 Days
3 Days
4-5 Days |
1-2
3-4
5+ |
Yes
No
Partially |
Yes
No |
Yes
No |
Poor
Fair
Good
Great |
|
|
|
Fitness Goals
Lose Body Fat
Gain Muscle |
Family History
Diabetes
heart Diesease
Stroke
Cancer |
Exercise
I exercise vigorously on a regular basis
I do not exercise that much |
Health Conditions
I smoke now - or - I have smoked in the last 5 years
I have High Blood Pressure
I have High Cholesterol |
|
|
