Bonnie Norman

Before you can book a session with Bonnie, we just need to know some more about you. Please fill out this form truthfully as this will allow Bonnie to make a training program specifically for you!

Name

First Name

Last Name

Phone

(###)

###

####

1. Has your medical practitioner ever told you that you have a heart condition, or have you ever suffered a stroke?

2. Do you ever experienced unexpected pains or discomfort in your chest at rest or during physical activity?

3. Do you ever feel faint, dizzy, or lose balance during physical activity/exercise?

4. Have you had an asthma attack requiring immediate medical attention at any time within the last 12 months?

5. If you have type 1 or 2 diabetes, have you had trouble controlling your blood sugar levels in the last 6 months?

6. Do you have any other conditions that may require special consideration for you to exercise?

7. What are your short-term goals?

8. What are your long-term goals?

9. What exercises/physical activity do you currently do and how often?

10. What exercises do you enjoy?

11. What exercises do you dislike?

12. Do you have any injuries or other health conditions that may limit your movement or training?

13. What days do you wish to do PT sessions?

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

What time of day do you wish to do PT sessions

Morning

Midday

Night

Bonnie Norman

Open 24/7