Please fill out this form, submit & continue to Page 2

All items are required unless otherwise specified.

1-Training and Health History Form

This form will take around 20 minutes to complete.

Fyi: It is best if you are uninterrupted to fill this out, as the form will reset if you leave it, thus leaving all your answers blank, and you would have to start again.

Information to be submitted includes contact info, training background, current training status, health information, nutritional information, and goals.

If you have access to any previous training or nutritional plans, you may attach them.

Body photos (front, side, back, side) and body measures (inches)will be uploaded to My PT Hub App, either the mobile app or through a web browser. Feel free to upload any gym photos, or send videos of your gym/equipment to facebook messenger or whatapp.

This form is on two pages, once you HIT SUBMIT on this page, you will be taken to a SECOND page.

Personal Contact Information

Body Statistics

in pounds (lbs)

Feet, Inches

in years.

Please check "yes" to say you are aware of this information.

Training - Current and Previous

Have you ever been on a training program before? Feel free to describe any exercises, reps, sets, cardiovascular work you have done in your previous trainings. Feel free to attach any previous training programs you have been on OR are currently doing.

Feel free to add a file containing any previous training you have done. You can upload up to 5 files in the following formats:

jpg, jpeg, png, gif, doc, pdf, xlsx, docx,xls,

Yes/No. Feel free to give further details.

What can you commit to considering all the other obligations you have in your life.

Please list any other fitness related activities and their frequency (days of the week, and times)

Of the following exercises listed below, rate your ability to perform the following exercises. Feel free to leave any comments if needed.

Please give the highest weight you have lifted, and then number of reps.

Please give the highest weight you have lifted, and then number of reps.

Please give the highest weight you have lifted, and then number of reps.

Please give the highest weight you have lifted, and then number of reps.

Please give the highest weight you have lifted, and then number of reps.

Please give the number of free body pulls you can perform or any variations that you can perform.

Feel free to comment/mention anything else you might feel is relevant to your training.

Health History

Please be very detailed when listing. Nature of injury/surgery/location/years/date:

Feel free to add explanation or comments on the above if needed.

Please describe dosages, and type of mediation and what it is treating.