Fitness Assessment Form

Assessment Type

Client Details

First Name

Last Name

Date of Birth

Phone Number

Emergency Contact Name

Emergency Contact Phone Number

Availability

Our personal trainers are available to meet with clients during our normal operating hours. Check our website for current facility hours at: www.uml.edu/crchours

Please list which days of the week/times you would be available to meet for your 1-hour fitness assessment.

Health History Questionnaire Form

Please Note: We cannot setup your fitness assessment with a personal until this form is completed. Depending on your answers we may be required to gain medical clearance before you can meet with your personal trainer. If medical clearance is necessary, we will work with your physician to gain this clearance and typically takes 2-3 business days.

Affiliation with University

Please check one

I am a

*required fields

Fitness Assessment Form

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