Personal Training Health History Questionnaire

The health questionnaire provides us with a comprehensive medical history. It also gives us information regarding your previous fitness history, and present and future fitness goals.

Physiqology Health Questionnaire Components

Part I – Health Concerns, Considerations, and Goals

• Health Goals: what are your most important health goals – lowering blood pressure, getting rid of back pain, losing weight, getting leaner?
• Musculoskeletal Considerations: have you had any surgeries or injuries, and when?
• Fitness Goals: What do you want to accomplish with your personal training program? By what date?
• Training Considerations: What time of day & days per week can you train?

Part II – Medications, Food Habits and Food Additives, Food Diary

What medications do you take? Why? What do you eat? What don’t you eat? These simple questions explain why you may be experiencing some of the problems in part one of our questionnaire. Before a personal trainer tries to make changes to your present lifestyle, they should know what you do at the present time.

Part III – Symptoms of Biochemical Imbalance

Part III is designed to zero in on the day to day functioning of your biochemistry. Approximately 150 multiple-choice questions are used to assess your areas of nutritional imbalance. These questions screen for:

• Food sensitivities or allergies
• Parasites
• Heavy metals / other sources of environmental toxicity
• Liver and gall bladder function
• Pancreatic function / blood sugar regulation
• Pituitary, thyroid, and adrenal gland function
• Areas of nutritional deficiency
• Sex-specific hormone levels, their metabolism, and detoxification

All of these factors influence your ability to lose weight, lose fat, increase your muscle mass, and improve strength and endurance. Improving your health helps you attain your performance goals.