information – Fitnessology

Contact Info

Prefix*

First*

Last*

Email address*

Cell Phone*

Personal Info

Unit*

Upload Full length front photo*

Example Image

Upload Full length side photo*

Example Image

Upload Full length back photo*

Example Image

Weight (Kg)*

Height (cm)*

Age*

Gender*

Training site location

For (One-on-One Training)-(Group Exercises)-(TRX – Suspension Training) Products

Weekly number of sessions

For (One-on-One Training)-(Group Exercises)-(TRX – Suspension Training) Products

Instagram Username*

Where did you hear about me?*

Do I have permission to post your progress pics and before/after on my social media and if so, do you care if I tag you or not?*

Body Composition Analysis history (ever gain or lost weight)*

Skin loose

Cardio and exercise time limitation

Meal Number taken limitation

Ability of meal preparation

Types of food limitations

Allergens

Supplements

Medicine

Smoking

Alcohol

Type of work

Level of daily activities

Working hours

Sleeping time

Wake up time

Access to any cardio machine or outdoor cardio activity

Target

MEDICAL HISTORY

Have you, or an immediate family member now or in the past experienced

Chest pain while exercising

Heart disease

Heart attack

Pacemaker

High blood pressure (>140/190)

Diabetes mellitus

Dizziness/Loss of Conscious

Currently pregnant

Depression

Low back pain

Nutrition relation disorder

Asthma

Bursitis

Arthritis

Tendonitis

Muscle Injury

Joint Injury

Smoking

Cancer

Osteoporosis

High Cholesterol (total > 200)

Note

Medical clearance may be required for individuals who meet or exceed certain risk factors prior to the first training session. In the event medical clearance is necessary for participation, you will be required to present LSU UREC with the provided form, signed and completed by your physician.

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Contact Info

Personal Info

MEDICAL HISTORY

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