Health History Betreff First name * Surname * Date of birth * Age * Email * Profession / Position * E-Mail-Adresse * Has a health professional ever told you that you may have a heart condition and advised you to exercise only under medical supervision? Have you experienced chest pains in the last month either while resting or during exercising? Have you experienced breathing problems either while resting or during exercising? Do you ever feel light headed? Do you snore? How is your sleep? Have you ever taken medication for high blood pressure, heart or respiratory problems? Do you know of any other reasons why you shouldn’t be physically active? Do you have any joint pains that could worsen with physical exercise? Do you have any oft he following illnesses? * Arteriosclerosis diabetes asthma Migraines Thyroid diseases Osteoporosis Osteoarthritis (joint wear) High blood pressure Low blood pressure rheumatism Are you currently experiencing any pain in the following places: * Throat/ neck Shoulders Upperback/ chest area Lower back Hips Knees Food / Ankle joint Have you ever had any injures on the places above? Please specify where. Have you ever had your disc prolapse? If yes, where and when? Are you pregnant? If yes, which month? Do you have Kids? Have you had a fever in the last 2 weeks? How would you rate your overall health at the moment? How would you rate your overall physical health? How would you rate your cardiovascular fitness? How many hours a day would you like to spend exercising/ moving ? What sports do you currently play/ do? How often per week and for how long? Do you do yoga? If yes, what kind? How often per week and for how long? How many hours of the day do you spend sitting down? Does your team have the opportunity to work at standing desks? What is you goal mentally? What is you goal physically? Do you have any wishes or expectations for you trainer? ✓ Meine Daten werden gemäß der Datenschutzerklärung verarbeitet. ✓ Es gelten die allgemeinen Geschäftsbedingungen.
