Starting Point Assessment – Courthouse Club Fitness

NAME*

First Last

PHONE*

EMAIL*

Choose the Courthouse Location you plan to attend for your Starting Point Assessment*

What do you currently do for exercise?*

How often do you take part in physical exercise?*

Have you been following this routine consistently for the past three months?*

On a scale from 1 to 10, how would you rate your nutrition (10 being the very best)?

Please enter a number from 1 to 10.

Click on the areas of nutrition you would like to improve*

On a scale from 1 to 10, how would you rate your stress level?*

Please enter a number from 1 to 10.

List your three biggest sources of stress (time, work, family, budget, etc.)*

Please select all that apply*

If anything, what could potentially stop you from reaching your fitness goals?*

How can a personal trainer help you (choose all that apply)?*

New Client Assessment Questionnaire