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We have been trained to a professional and competent level through " Premier Training ® " in order to prescribe, plan and deliver safe and effective excercise programmes to meet individual needs and to suit all levels of fitness.

We carry out an initial session that is free of charge, which comprises of a consultation, a fitness test, body fat measurement and blood pressure reading. Your results will be confidentially recorded and your progress monitored monthly.

Our facilities will allow you to train in a friendly and relaxed atmosphere and with professional advice and encouragement, you can achieve your goals.


Please help us to assist you by completing the following no obligation questionaire :

Pre-Excercise Screening Form

 

*Full Name :

*D.O.B. (mm/dd/yyyy) :

*Address :

*Line 2 :

*Line 3 :

*Postcode :

Tel (day )

Tel ( evening ) :

*E-mail :


Have you ever suffered from any of the
following medical conditions?

YES

NO

Diabetes

Stress of high/low blood pressure

Asthma or respiratory illness

Heart or chest pains

Epilepsy, fainting or dizziness

Neck or back pain

Hip pain

Knee pain

Any other joint injury ( please specify )



Do you smoke?

Are you pregnant?

Have you recently had a baby?

Are you on any medication?

Do you have any illness that may be aggravated by regular excercise?

Do you currently do regular exercise?

What are your main fitness & health objectives?

By submitting this form you are under NO obligation to enter into a contract. This form is for information purposes only, no fees or penalties apply.
All information will be held in strict confidence.

Thank you.

Mark Honeyghan.



















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