Personal Training
Nutrition
About
Services
Podcast and Articles
Contact

Fitness Class Enrolment Form

Aaron Morton logo

Fitness Class Enrolment Form

Before you begin your first fitness class with Aaron Morton Training please could you complete the following health form so I can be informed by any health issues that may influence your fitness class participation.

Thank You,

Aaron Morton

Name*
Address*
Email Address*
Emergency Contact Details (Only Fill Out If Having PT Package)
Doctors Details (Only Fill Out If Having PT Package)
Have You Experienced Any Heart Problems*
If 'Yes', Specify in what in 'other' box
- Yes
- No
Do You Have Diabetes?*
If 'Yes', Specify in what in 'other' box
- Yes
- No
Have You Ever Had A History Of Cancer?*
If 'Yes', Specify in what in 'other' box
- Yes
- No
Do You Suffer From Epilepsy?*
- Yes
- No
Do You Ever Experience Pains In Your Chest or Heart During Physical Activity?*
If 'Yes', Specify in what in 'other' box
- Yes
- No
Do You Ever Get Dizzy Spells?*
If 'Yes', Specify in when in 'other' box
- Yes
- No
Do You Get Out Of Breathe Easily?*
If 'Yes', Specify in when in 'other' box
- Yes
- No
Do You Have Joint or Bone Problems That Could Be Aggravated By Exercise?*
If 'Yes', Specify in what in 'other' box
- Yes
- No
Has Your Doctor Ever prescribed Medication For Blood Pressure Or Heart Conditions?*
If 'Yes', Specify in what in 'other' box
- Yes
- No
Are You Currently Pregnant?*
- Yes
- No
Have You Given Birth Within The Last 2 Years?*
If 'Yes', Specify in when in 'other' box
- Yes
- No
Have You Been Advised Against Physical Activity By Your Doctor?*
If 'Yes', Specify why in 'other' box
- Yes
- No
Have You Had Any Surgery In The Last 10 Years?*
If 'Yes', Specify what in 'other' box
- Yes
- No
Do You Have High Blood Pressure*
If 'Yes', Specify when last tested in 'other' box
- Yes
- No
- Not Sure
Do You Have High Cholesterol?*
If 'Yes', Specify what and when last tested in 'other' box
- Yes
- No
- Not Sure
Do You Have A History Of Heart Disease In Your Family?*
- Yes
- No
- Not Sure
Do You Smoke?*
If Used To, Specify When You Quit In The 'Other' Box
- Yes
- No
Please Specify In The Box Anything Else Not Covered Above You Think I Should Know In Relation To Your Health & Medical History?
On A Scale 1-10 (1 Mega Stressed - 10 Mega chilled) How would rate your levels of stress?*
What Factors Would You Say Stress You Out The Most On A Regular Basis?*
On Average How Many Hours Sleep Do You Get A Night?*
How Would You Rate The Quality Of Your Sleep? (1 - Have trouble getting to sleep & regularly wake up - 5 I'd sleep through a hurricane)
How Would You describe Your Energy Levels Over The Day?*
Describe what an ideal fitness class would involve for you?*

What is your Everyday Health Score?

Take The Quiz

Personal Training
Nutrition
About
Services
Podcast and Articles
Contact