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Below you will find an initial consultation form, followed by a PARQ form and then a training preference questionnaire. If you are interested in working with me, then please complete and submit the forms, and I will aim to contact you within 24 hours to arrange a call for a discussion around your requirements. By submitting the forms, you are under no obligation to work with me. However, after our discussion, if you feel I am the right trainer for you, you can book in for a session. Alternatively, you can send me an email with any questions or arrange a call to discuss things further, or you can catch me in the gym. I am more than happy to help!

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info@bedrockpersonaltraining.com

Bedrock Personal Training

PureGym

9, Bidston Moss, Wallasey

CH44 2HE ·

Wirral

Consultation Form

Birthday
Do you smoke/vape?
Do you drink alcohol?

PHYSICAL ACTIVITY READINESS QUESTIONNAIRE (PAR-Q)

Has your doctor ever said that you have a heart condition and that you should only perform physical activity recommended by a doctor?
Do you feel pain in your chest when you perform physical activity?
In the past month, have you had chest pain when you were not performing any physical activity?
Do you lose your balance because of dizziness or do you ever lose consciousness?
Is your doctor currently prescribing any medication for your blood pressure or for a heart condition?
Do you have a bone or joint problem that could be made worse by a change in your physical activity?
Are you currently pregnant or have you given birth in the last 6 months?
Have you undergone surgery within the last 12 months?
Do you know of any other reason why you should not engage in physical activity?

If you have answered YES to one or more of the above questions, consult your GP before engaging in physical activity. Tell your physician which questions you answered YES to. After medical evaluation, seek advice from your GP on what type of activity is suitable for your current condition.

Training preferences

Monday
Monday
Monday
Monday
Monday
Monday
Monday
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