Starting Point Assessment Thank you for scheduling your Starting Point Assessment. If you can take a few minutes and fill out the following questionnaire, it will help us to understand what your training needs are. We look forward to seeing you in our club soon! NAME* First Last PHONE*EMAIL* Choose the Courthouse Location you plan to attend for your Starting Point Assessment* Battle Creek (South Commercial) West Salem Keizer South River Road Lancaster What do you currently do for exercise?*How often do you take part in physical exercise?*1-2 times per week3-4 times per week5-8 times per weekI do not currently exerciseHave you been following this routine consistently for the past three months?*YesNoOn 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* Finding healthy snacks Eating at restaurants Meal prep Drinking water Increasing protein Portion Control Emotional Eating 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* I am currently in physical therapy I have an upcoming surgery scheduled I have bone/joint problems I have other health concerns that cause pain and/or limitation I have no current injuries If anything, what could potentially stop you from reaching your fitness goals?*How can a personal trainer help you (choose all that apply)?* Lose body fat Develop muscle tone Rehab an injury Nutrition education Start an exercise program Advance my exercise program Safety Athletic Training Increase muscle mass Motivation and accountability