HWS Personal Training

 

Contact Information:

Name:

Phone #:

Date:

Availability Information:

Please check all available dates and times that you are able to train.

Sunday:

9 a.m.

10 a.m.

11 a.m.

12 p.m.

1 p.m.

2 p.m.

3 p.m.

4 p.m.

5 p.m.

6 p.m.

7 p.m.

8 p.m.

9 p.m.

Monday:

6 a.m.

7 a.m.

8 a.m.

9 a.m.

10 a.m.

11 a.m.

12 p.m.

1 p.m.

2 p.m.

3 p.m.

4 p.m.

5 p.m.

6 p.m.

7 p.m.

8 p.m.

9 p.m.

Tuesday:

6 a.m.

7 a.m.

8 a.m.

9 a.m.

10 a.m.

11 a.m.

12 p.m.

1 p.m.

2 p.m.

3 p.m.

4 p.m.

5 p.m.

6 p.m.

7 p.m.

8 p.m.

9 p.m.

Wednesday:

6 a.m.

7 a.m.

8 a.m.

9 a.m.

10 a.m.

11 a.m.

12 p.m.

1 p.m.

2 p.m.

3 p.m.

4 p.m.

5 p.m.

6 p.m.

7 p.m.

8 p.m.

9 p.m.

Thursday:

6 a.m.

7 a.m.

8 a.m.

9 a.m.

10 a.m.

11 a.m.

12 p.m.

1 p.m.

2 p.m.

3 p.m.

4 p.m.

5 p.m.

6 p.m.

7 p.m.

8 p.m.

9 p.m.

Friday:

6 a.m.

7 a.m.

8 a.m.

9 a.m.

10 a.m.

11 a.m.

12 p.m.

1 p.m.

2 p.m.

3 p.m.

4 p.m.

5 p.m.

6 p.m.

7 p.m.

8 p.m.

Saturday:

9 a.m.

10 a.m.

11 a.m.

12 p.m.

1 p.m.

2 p.m.

3 p.m.

4 p.m.

5 p.m.

6 p.m.

Physical Activity:

Height

Weight

Age

In the past year, how often have you engaged in physical activity?

Regularly (3-4 times/week)

Semi Regularly (1-2 times/week)

Sporadic (1-2 times/month)

None

Please explain your current exercise regime or activities performed in the past:

When you exercise, rate your perceived exertion:

Light

Fairly Light

Somewhat Hard

Hard

Do you start exercise programs but then find yourself unable to stick with them?

Yes

No

What are your personal barriers for not exercising or sticking to a program?

What types of exercise interest you? (Please check all that apply)

Walking

Cycling

Stationary biking

Stair climbing

Jogging

Traditional aerobics

Elliptical striding

Swimming

Yoga/Pilates

Strength Training

Racquet sports

Other:

Please list any activities that you don’t like:

Rank your goals in undertaking exercise. Rate each goal separately on a scale of 1 (Not important) - 10 (Extremely important).

Improve cardiovascular fitness

Reduction in Body-fat/Weight

Reshape or tone my body

Improve performance for a specific sport

Improve moods/ability to cope with stress

Improve flexibility

Increase strength

Increase energy level

Feel better

Enjoyment

Other

Health Patterns:

How many meals and/or snacks do you have per day?

On average, how much water do you drink per day?

Do you minimize your intake of sweets, especially candy and soft drinks, and avoid adding sugar to foods?

Yes

No

Is your diet well-balanced (including vegetables, fruits, breads, cereals, dairy products, and protein?)

Yes

No

Overall, do you feel healthy?

Yes

No

What are your energy levels like throughout the day?

Stress & Social Support:

How do you deal with stress normally?

Do you make decisions with minimum stress and worry?

Yes

No

Do you have one or more persons with whom you can discuss personal concerns, worries, or problems?

Yes

No

Do you have someone who will be supportive of your health and fitness goals?

Yes

No

Occupation & Leisure:

What is your present occupation?

Does your occupation require much activity (i.e., walking, getting up & down, carrying things?)

What are your usual leisure activities?

Expectations:

Why have you decided to begin or improve your exercise program and hire a personal trainer?

Specifically describe what goals you like to accomplish through your fitness program during the next:

1 month:

4 months:

1 year:

What are you looking forward to most about starting a personal training program?

 

CONTACT

Bristol Field House
283 Hamilton Street
Geneva, NY 14456
Front Desk: (315) 781-3528
Office: (315) 781-3901
Recreation@hws.edu

 

HOURS

Monday-Thursday 6 a.m.-11:30 p.m.
Friday 6 a.m.-9 p.m.
Saturday 9 a.m.-6 p.m.
Sunday 9 a.m.-11 p.m.

 

Client Profile

Client Profile (PDF)

Client Profile (Word)


Preparing Students to Lead Lives of Consequence.