QUESTIONNAIRE

In order for Shadow Fit to provide you with a personalized workout that is designed to your exact needs, we need some info. Don't worry all your personal stuff is safe with us and we won't sell or trade your information. For certain things like when we ask about Bone or Joint pain, be pretty selective. If you click one of those boxes it will reduce the amount of exercises available to you. If you truly have a chronic pain in your elbow then let us know. If you had a pain for a few days last week, than we suggest you leave that off. Please answer all of these questions as truthful as possible; it will help us give you the best program possible. Don't forget you can always come back and edit this info at any time so don't stress about your decisions. In a few minutes you'll be on your way!

Personal Information (Part I of IV)
First Name:
Last Name:
Birthdate: / /
Sex: Male Female
Email Address:
Password:
Password (2):
Zip Code:
Country:

By clicking that selection we request that you visit a physician before participating in a Shadow Fit program. Although we would love to have you in the community we highly recommend getting professional help from a personal trainer or other health/fitness professional. These issues are all very personal and it is hard to design a program unless hearing your personal situation.

I have recently been cleared by a physician to partake in the Shadow Fit program.

Health History (Part II of IV)
Do you currently have or have had in the past?
History of heart problems such as chest pain, or stroke? Yes No
Any Chronic Illness or condition? Yes No
Difficulty with physical activity? Yes No
Advice from a physician not to exercise? Yes No
Recent surgery (last 12 months)? Yes No
History of breathing or lung problems? Yes No
Pregnancy (currently or in last 3 months)? Yes No
Hernia or any condition that was a cause of exercising? Yes No
Do you know of any reason that you should not exercise? Yes No
Any of these Health Concerns?
Hypertension   Diabetes   Arthritis   Lung Disease   Obesity   Heart Disease   Cancer   Osteoperosis 
Bone or Joint Issues?
Elbow Pain   Back Pain   Shoulder Pain   Knee Pain   Hip Pain  
Have you ever been told to avoid movement with those specific bone or joint pains? if so which one?

By clicking that selection we request that you visit a physician before participating in a Shadow Fit program. Although we would love to have you in the community we highly recommend getting professional help from a personal trainer or other health/fitness professional. These issues are all very personal and it is hard to design a program unless hearing your personal situation.

I have recently been cleared by a physician to partake in the Shadow Fit program.

Excercise History & Goals (Part III of IV)
Where Do You Exercise?
We recommend that you at least have a stability ball and dumbbells.
If you plan on only using your body weight, the available exercise selection will be drastically reduced.
Home
Neighborhood Gym
Small Club
A Large Club
On your average training day, what equipment will you have available to you?
Body
Treadmill
Eliptical
Bike
Stepper 		Step Up
Foam Roll
BOSU Ball
Stability Ball
Dumbbells 		Smith Machine
Barbell
Balance Stuff
Mini Bands
Exercise Bands 		EZ Curl Bar
Typical Weight Machines
How many days and what days do you wish to train?
if your not sure which days you would can exercise but know you want to exercise on 3 days than click the three that are you are most likely to train on.
Monday   Tuesday   Wednesday   Thursday   Friday   Saturday   Sunday 
For how long do you anticipate each training session to last?
30 Minutes  1 Hour   1 1/2 Hours 
What would you say that your current fitness level is?
Terrible (The most phyiscal activity I do is lifting the remote to change the channel)
Poor (Walking up a few flights of stairs makes me breath heavily)
Average (I don't do much physical activity, but I do some.)
Pretty Good (Physical activity is a pretty steady part of my life)
Great (I should tryout for the American Gladiators)
Unbelievable (Lance Armstrong, Watch Out!!!)
What would you say your body type is?
Thin (I could gain some weight)
Average
I could be a fitness model
Little Chuby (I could loose a few lbs, Momma says im big boned (could lose 5-20lbs)
Obese (I really need to lose some serious weight (should lose 20+ lbs)
What would you rate your knowledge and ability of weight training and physical fitness?
Beginner (I had to look up weight training in the dictionary)
Intermediate/Advanced (I have worked out off and on for years, and read those fitness magazines here and there)
Advanced (I work out pretty regularly and have subscritions to some of those fitness magazines)
What exactly are you looking to get out of this?
Weight Loss Reduce Joint Pain Max Strength
(You must be either in a small club or a large club ) 		Hypertrophy
(You must be either in a small club or a large club) 		Improve Overall Fitness
Are there any parts of the body that you want to focus on?
Legs   Arms   Stomach   Hips   Calves   Chest   Back   Forearms 

Personal Stats (Part IV of IV)
If you know any of these answers it will be a great help to us, this will only help get you a more specific exercise plan.
Body Fat %
Height Feet: Inches:
Weight
One being not motivated and 10 being highly motivated where would you say you are right now with reaching your fitness goals?
1   2   3   4   5   6   7   8   9   10  
How hard are you willing to work to reach your goals?
1   2   3   4   5   6   7   8   9   10  
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