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MEDICAL AND GOAL FORMS

MEDICAL AND GOAL FORMS

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Question 1 of 16

Athletes First And Last Name

Question 2 of 16

Parents First And Last Name (if child under 18 years)

Question 3 of 16

Address

Question 4 of 16

Date of Birth

Question 5 of 16

Contact Number

Question 6 of 16

Do You Experience Or Have You Experienced

(Select all that apply)
A

Sleeping Problems

B

Surgery

C

Arthritis

D

Broken Bones

E

Neck Or Back Pain

F

Joint Pain Or Muscular Pain

G

Cramps Or Fatigue

H

Knee Or Shoulder Pain

I

None Applies

Question 7 of 16

If You Answered YES To Any Of The Above, Please Explain?

Question 8 of 16

Are You Currently Taking Any Prescribed Medication, If So Please Explain?

Question 9 of 16

Have you had any surgeries, serious injuries, or health concerns? If so please explain in detail below.

Question 10 of 16

Physically, What Main Area's Do You Think You Need To Work On?

(Select all that apply)
A

Aerobic Or Anaerobic Endurance

B

Strength / Power Upper Body

C

Strength / Power Lower Body

D

Core Strength

E

Reaction

F

Mental Fitness

G

Agility/Speed/Footwork

Question 11 of 16

What Would You Like To Achieve In The Next 3 Months? (Please Be Specific)

Question 12 of 16

What Is Your Long Term Goal? e.g. become a sports pro, go to college, improve health (Please be specific)

Question 13 of 16

What Are The Main Issues Blocking You From Your Goals? e.g. Finances, Support, Training Plan, Time Constraints, Confidence (Be Specific) 

Question 14 of 16

Is there anything else that we need to consider when performing your program?

Question 15 of 16

Please give us a detailed description of your weekly schedule below. Please be as specific as possible.
Eg Monday - 7-8am Fitness, 9-3pm school, 6-8pm Tennis Practice, 8-8.30pm Stretching

 

 

Question 16 of 16

PLEASE TELL US IF YOU SUFFER INJURY OR IF YOUR HEALTH CONDITION CHANGES.
Statement of Understanding & Consent
Disclaimer

I hereby warrant to Tennis Fitness Trainer that all the information on this form is correct. I acknowledge that I will not have any claim of any kind or nature against Tennis Fitness Trainer for any illness or adverse medical condition or state of health arising directly or indirectly from any test or training program under Tennis Fitness Health Trainer. I acknowledge that I will not have any claim of any kind against Tennis Fitness Trainer should any accident to my person or damage/loss of property occur. I further more declare myself familiar with all rules and regulations in force as laid down by Tennis Fitness Trainers and agree to always adhere there to. Tennis Fitness has a 24hour cancellation policy. If you were to cancel your session within 24hours, full payment is charged.

 

(Select all that apply)
A

I AGREE

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