Agency 9 fields Industry-Specific

Health & Fitness Assessment Template

Initial fitness assessment questionnaire.

Full Name *

Age *

Height

Weight

Current Activity Level

Sedentary (little exercise) Light (1-2 days/week) Moderate (3-4 days/week) Very Active (5+ days/week)

Current Injuries / Limitations

Describe Your Typical Diet

Average Sleep Per Night

Form Fields

Field	Type	Required
Full Name	Text	Required
Age	Number	Required
Height	Text	Optional
Weight	Text	Optional
Fitness Goals	Checkbox	Optional
Current Activity Level	Radio	Optional
Current Injuries / Limitations	Textarea	Optional
Describe Your Typical Diet	Textarea	Optional
Average Sleep Per Night	Select	Optional

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1 Year Updates & Support

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