Please complete the following online Health and Fitness History form in order for my team and I to have a better idea if we’re the perfect fit for what you’re looking for. 

3Q Fitness Studio is currently accepting a limited clientele (50 total clients) to dedicate our knowledge, passion, and resources to help them reach their fitness goals in our state-of-the-art, private studio. All personal training sessions are by appointment only and clients are selected through our online Health and Fitness History form.

Once you’ve submitted the form, you will be contacted within 24 hours to set up your complimentary JumpStart fitness and nutrition consultation.  Are you ready?
First Name *
Last Name *
Email *
Birthdate (Month/Day)
Daytime Phone *
Male or Female *
Height
Weight
Optimal Time Of Day For You To Exercise *
Occupation
How did you hear about us? *
Have you ever been told you should only do activity recommended by a doctor? *
Yes   No
Do you feel pain in your chest when you do physical activity? *
Yes   No
In the past month, have you had chest pain while you were inactive? *
Yes   No
Do you lose balance due to dizziness or losses of consciousness? *
Yes   No
Do you have bone or joint problems that become worse with physical activity? *
Yes   No
Has your doctor ever prescribed drugs for your blood pressure or heart? *
Yes   No
Do you know of any other reason why you should not do physical activity? *
Yes   No
If yes, please explain.
How many days a week are you currently working out? (0-7x) *
How long are your typical workouts? *
How many days a week do you realistically see yourself working out? *
Describe Your Ideal Personal Trainer (personality, special interests, etc.) *
What are your fitness goals (weight loss, more tone, more energy, etc.)? *
What are your interests (running, biking, swimming, boxing, etc)? *
Why should you be chosen as a candidate to work with us at the Studio? *