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Personal Training Interest Form

First and Last

Must be a valid email address

How do you prefer to be contacted?

How did you hear about us?

Do you prefer a male or female trainer?

Check each box that is true for you

If any of the above health questions were true for you, the Health and Fitness Lab staff requires that you provide a written physician's consent prior to scheduling an appointment.

Do you smoke, or have you quit smoking within the previous 6 months?

Do you take prescription medication(s)?

The following questions are fitness specific questions. Please answer with as much detail as possible so we can best pair you with a trainer.

How would you rate your experience with strength exercises?

Have you been exercising consistently for the past 3 months?

If you answered YES to the previous question, please answer the next 3 questions.

How often do you take part in physical activity?

Where do you exercise?

If you answered NO to exercising consistently for 3 months, please answer the following question.

Please answer all of the following questions.

Please check all days/times you would prefer to meet with the trainer.

How many days per week do you want to work with a trainer?

Thank you for filling out our interest form! Due to our limited number of trainers, we cannot guarantee you a trainer. We will reach out to you in 1-2 business days, but if you have not heard from us, please follow up by emailing christina.sorentino@wku.edu.


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 Last Modified 7/22/21