Personal trainer to help you lose fat near me East Meadow Massapequa
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Health Questionaire/ Intake Form
These forms are confidential and for our records only
Indicates required field
Emergency Contact Name
What are your goals?
EMERGENCY Contact Phone Number
In order for us to know you better and design a fitness program that is best for you, please provide the following health history information. All information is strictly confidential
Do you have or have you ever had problems with:
Any Other Issues You want to add
Do you smoke?
Do you have any past or present injuries or limitations? (List dates and years) (nothing is too small)
Do you feel pain in your chest when you do physical activity? *
Please list any surgeries you have had:
If my health and/or medications should change during our time working together, I understand that I am responsible for informing AB Fitness & Nutrition Center?
Are you currently taking any medications? If Yes please list and the amounts
Coaching Style Questionnaire
These questions help the coaches at AB Fitness deliver the best experience possible for you. Please choose the response that feels closest to your feelings.
How quickly are you expecting to see results?
I know they will come
However long it takes
No rush, I am here for long term results
Beyond working out, What do you expect from us?
To be challenged and pushed
To enjoy the process and the people
To feel comfortable and supported in the gym
To learn new things (science of exercise/nutrition)
What would make you unhappy here?
Not being challenged enough
Lack of positive reinforcement/energy/support
Too intimidating/not comfortable
Lack of structure
AB Fitness Center Personal Training Rules & Agreement
Please Initial after each rule
Program Structure: Our sessions are 30 minute Semi Private training with a MAX of 6 people to 1 Trainer. Each person will receive individual attention based on your goals. Sessions also begin promptly at their scheduled time. If you are late there is no make up time.
Refunds: I understand and agree that there are absolutely NO REFUNDS. I understand and agree that all sessions will NOT rollover. Failure to complete total sessions within the 28 day billing cycle will result in the forfeit of any remaining sessions and no refunds will be given for any remainder sessions. Sessions are NOT transferable.
Autopay: Our billing system is structured weekly so you will be billed every 28 days...7 days in a week x 4 weeks in a month= 28 day billing structure. Your billing date will always move due to this. Also if you complete your allotted sessions before your billing date it will trigger the system to start a new block for you. You can check when your next billing date is in your Zen Planner app by clicking on your initials in the left hand corner. You will be billed until you submit a cancellation request...see below
If at any point you need to cancel your contract please due so 30
to your next billing cycle. Send us an email with your reason for cancellation. We will then reach out to you to set up a phone call to go through the procedure. You will be charged until you submit our website form to do so
“I acknowledge that I am making this commitment to myself and to AB Fitness & Nutrition Inc. I will not quit before the end of this commitment, I expect AB Fitness to hold me accountable to completing this commitment, and I agree to give my best and assume full financial responsibility for this commitment.” (Please Initial Below)
WE ARE SUPER EXCITED TO WORK WITH YOU!!!
Call Us to Get Started
Join us at One of Our Personal Training Locations:
East Meadow Personal Training Studio
514A East Meadow Ave
East Meadow NY 11554
Massapequa Personal Training Studio
4150C Merrick Road
Massapequa NY 11758
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