Flexiva Fitness and Weight Loss Program

Please complete the following information to enroll in our Fitness and Weight Loss Program

Personal Information:

Address:

Health Information:

Do you have any existing medical conditions or health concerns?

Are you currently taking any medications?

Fitness and Weight Loss Goals:

Please briefly describe your fitness or weight loss goals:

Previous Exercise Experience:

Have you participated in any fitness or exercise programs before?

Age, Weight, and Height:

Program Selection:

Certainly, here are some additional health-related questions that can help you better understand the health and fitness status of your customers:

Health History:

Do you have any allergies, food sensitivities, or dietary restrictions we should be aware of?

Have you undergone any surgeries or medical procedures in the past?

Are you currently experiencing any pain or discomfort, particularly in the joints or muscles?

Medical Conditions:

Do you have a history of chronic medical conditions such as diabetes, hypertension, heart disease, or respiratory conditions?

Are you currently under the care of a healthcare provider or specialist for any medical condition?

Medications and Supplements:

Are you taking any dietary supplements, vitamins, or herbal remedies?

Are you currently using any mobility aids or assistive devices, such as crutches, braces, or a wheelchair?

Lifestyle and Habits:

Do you smoke or use tobacco products?

Do you consume alcoholic beverages?

Fitness History:

How would you describe your current fitness level?

Have you previously worked with a fitness trainer or participated in any exercise programs?

Are there any specific fitness goals you would like to achieve through our program, such as weight loss, muscle gain, improved flexibility, or increased cardiovascular fitness?

Nutrition and Diet:

What is your typical daily dietary intake like? Are you following any specific diet plan or eating regimen?

Do you have any dietary preferences or restrictions, such as vegetarian, vegan, gluten-free, or other dietary choices?

Additional Information:

Is there any other health-related information you believe is important for us to know in order to provide you with the best fitness and weight loss program experience?

By gathering comprehensive health-related information, you can tailor your fitness and weight loss programs to the specific needs and goals of each customer, ensuring a more effective and personalized approach to their well-being journey. Remember to handle this information with care and in compliance with privacy regulations.

By submitting this application, I acknowledge that I have read and agree to abide by the terms and conditions of Flexiva Fitness and Weight Loss Program.