Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Personal Fitness Training Inquiry Form

  1. Contact:

    (314) 963-5624

  2. Best way to reach you?*

  3. Please complete the following information so we can place you with the trainer who will best meet your needs.

  4. Have you spoken with either:

  5. When do you prefer the training sessions to be? Check all that apply.

  6. Physical Activity Readiness Questionnaire (PAR-Q)

  7. Has your doctor ever said that you have a heart condition and that you should only perform physical activity recommend by a doctor?*

  8. Do you feel pain in your chest when you perform physical activity?*

  9. In the past month, have you had chest pain when you were not performing any physical activity?*

  10. Do you lose your balance because of dizziness or do you ever lose consciousness?*

  11. Do you have a bone or joint problem that could be made worse by a change in your physical activity?*

  12. Is your doctor currently prescribing any medication for your blood pressure or for a heart condition?*

  13. Do you know of any other reason why you should not engage in physical activity?*

  14. General & Medical Questionnaire

  15. Does your occupation require extended periods of sitting?*

  16. Do you partake in any regular recreational activities or hobbies (fitness center exercise, golf, tennis, skiing, hiking, gardening, etc?) If yes, please explain below:*

  17. Has a medical doctor every diagnosed you with a chronic disease (coronary heart disease, diabetes, hypertension, high cholesterol, other) If yes, please list below:*

  18. Do you get 7-9 hours of sleep most nights? *

  19. Did you eat breakfast this morning? *

  20. Do others live in your household?*

  21. Thank you for completing our inquiry form, we will follow up very soon. If you have questions, please call Dave at (314) 963-5624, email: reddyd@webstergroves.org or visit WGFitnessGroup.org.

  22. Leave This Blank:

  23. This field is not part of the form submission.