Run Fit Crew Customized Training Plan

  • Run Fit Crew Customized Training Plan

  • Client Intake & Health-Assessment Form

  • Sex*
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Are you currently a member of Run Fit Crew?*

  • Pre-Health Screening Questions

  • 1. Do you have any heart conditions, chronic illnesses, recent injuries (within the last 6-months) or medical conditions that may affect your ability to participate in a fitness program?"*
  • 2. In the past month, have you had chest pain when you were NOT doing physical activity?*
  • 3. Has your doctor ever said that you have a heart condition or that you should only do physical activity recommended by a doctor?*
  • 4. Do you feel pain in your chest when you do physical activity?*
  • 5. Do you lose your balance because of dizziness or do you ever lose consciousness?*
  • 6. In the past month, have you had chest pain when you were NOT doing physical activity?*
  • 7. Do you have a bone or joint problem that could be made worse by a change in your physical activity?*

  • If you answered YES to any of the above questions (1-7), please stop here and do not proceed with this form. Your safety is our top priority. Please schedule a consultation with Coach P to discuss your health history and determine whether you can safely complete this program.

  • Click here Schedule a free consultation with Coach Patricia

  • If you answered NO to the above questions, please continue with the form.

  • Health Assessment Questionnaire

    The following questions are based on the Physical Activity Readiness Questionnaire (PAR-Q). Please answer honestly. This information is confidential and used solely to design a safe, effective training plan.
  • Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition?*
  • Are you pregnant or have you been pregnant in the last 6 months?*
  • Do you have diabetes or blood sugar issues?*
  • Do you have asthma or any other respiratory condition?*
  • Do you have any known allergies (food, environmental, medications)?*
  • Have you had any surgeries or injuries in the past 2 years?*
  • Do you have any other medical condition I should be aware of?*

  • 6-Week Customized Training Plan*

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    Training Plan Deposit. A non-refundable deposit is required to secure your spot and initiate your assessment. By submitting payment you acknowledge and agree that this deposit is non-refundable. Refunds will only be issued at the sole discretion of Coach Patricia in cases where a client is determined to be ineligible to participate in the program.
    Training Plan Deposit

    A non-refundable deposit is required to secure your spot and initiate your assessment. By submitting payment you acknowledge and agree that this deposit is non-refundable. Refunds will only be issued at the sole discretion of Coach Patricia in cases where a client is determined to be ineligible to participate in the program.

    $79.50$79.50
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