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Thank you for your interest in a FREE trial session! Please fill in the details below and hit the submit button. We will then contact you to arrange a suitable time.

Note that fields marked with a * are required. If you wish to submit these forms by post please click here.


First name: *

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How did you hear about us? If other, please describe:

What sort of personal training would you like to try?

What time of the day will suit you for your training sessions?

Do you have a preference for trainer? (click here to view trainers, opens new window)

Would you like to subscribe to our free monthly Health and Fitness newsletter? Yes No


Health screen

The following questions are required to assess your health status before starting a fitness program. The answers you give are completely confidential and will not be released without your prior permission. Please answer all questions with either a yes or no.

YesNo Has anyone is your family under 60 suffered heart disease, stroke, sudden death, or rasied cholesterol?

YesNo Are you over 40 and NOT used to regular exercise?

YesNo Are you on any prescription medication? If yes, please state:

YesNo Have you been hospitalised recently? If yes, please state why:

YesNo Do you smoke?

YesNo Have you given birth in the last six weeks?

YesNo Are you pregnant? If so, how many weeks?


Health conditions and risk assessment

Have you had or do you currently have any of the following? Check if yes, leave blank if no.

Asthma

Raised cholesterol

Diabetes

Any heart condition

Liver or kidney condition

Diziness or fainting

High blood pressure

If yes, please state your blood pressure:

Palpitations or chest pain

Hernia

Arthritis


Injuries, breaks, sprains etc

Have you ever had or do you have any pain or major injuries in the following areas:

Neck

Back

Shoulder

Knees

Ankles

Cramps or muscular pain

Other area(s)

If you answered yes to any please describe the injury:

Are there any other conditions which may be reason to modify your fitness program?

If yes, please state:



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What's New?

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