"I went home knowing I was probably the healthiest I'd ever been in my life."

London Evening Standard
Outstanding Value. fitscape 7 night fitness holidays from £1,495 per person all inclusive.
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"I thought my holiday would be good but I was unprepared for how brilliant I would feel by the end of the week..."

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04.02.12

Fitness Profile Form

Name  
Date of Birth  
Email address  
Repeat email address  
Mobile telephone number  
Occupation  
Height  
Weight  
Sex:  
T-shirt size  
Date of Travel  
     

Person to contact in case of emergency:
 
 
 
     
Travel Details    
 
     
Please specify your outgoing flight details including flight number, departure and arrival times.
     
Please specify your return flight details including flight number and departure time.
     
Travel Insurance Details    
Insurance company name  
Insurance policy number:  
Insurance company emergency telephone number:  
     
Medical details and physical activity readiness
This section of the form has been designed to identify anyone for whom physical activity might be inappropriate or those who should have medical advice concerning the type of activity most suitable for them. It also gives our personal trainers the opportunity to review everyone’s fitness levels in advance and prepare the schedules accordingly.
     
Has your doctor ever said you have heart trouble?
yes No
If so, please specify:
     
Do you ever have pains in your heart and chest?
yes No
If so, please specify
     
Do you ever feel faint or have spells of dizziness?
yes No
If so please specify
 
Has your doctor ever told you that you have a bone or joint problem, such as arthritis that has been aggravated by exercise, or might be made worse with exercise?
yes No
If so please specify
 
Do you suffer from any problems of the lower back
yes No
If so please specify
 
Are you currently taking any medications?
yes No
If so please specify
 
Do you currently have a disability of a communicable disease?
yes No
If so please specify
 
Do you have any other medical issues or injuries that you should inform us about
yes No
If so please specify
 
Is there a good physical reason, not mentioned here, why you should not follow an activity programme even if you wanted to?
yes No
If so please specify
     

Your Current Fitness / Activity Programme
Describe your fitness level.
Describe a typical week's exercise
What are your preferred activities/sports?
Provide details of any event(s)/races you have participated in as well as your finishing times.
 
Is there any activity you don't enjoy or that injury prevents you from participating in?
yes No
Describe
 
Diet
Do you eat...

Fish? Yes No
Poultry? Yes No

Do you have any other special dietary requirements?   yes No
If so, please specify.
How many units of alcohol do you consumer per week?
Do you smoke?  yes No
If so, how many cigarettes per day?


Any additional information?
     
Aims and Expectations
What are your fitness goals for your time with fitscape?
What are your fitness goals for the next 3 to 6 months?
* Please tick here to confirm that you have read, understood and answered all questions to the best of your knowledge
Many thanks for your time.