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Pre-Exercise Assessment

Before your first personal training session or online coaching block, this assessment helps Jordanna understand your body, your history and your goals — so everything is built safely around you.

Take your time and answer as honestly as you can — there are no wrong answers, and nothing here is judged. Your answers are treated confidentially and used only to design safe, personalised training. 🌿

Your details

Full name

Contact number

Date of birth

Your goals

What would you love to achieve? (strength, energy, pain-free movement, confidence — anything)

Preferred training days

Pain or injury

Do you currently have (or have a history of) pain or injury in any of these areas?

Tell me more about any pain, injuries, surgeries or areas we should take care with

Medications

Are you currently taking any of the following?

Other medications (including thyroid medication, antihistamines, etc.)

Health conditions

Pregnant (now or in the last 12 months) Epilepsy Arthritis Asthma

Other conditions I should know about

Heart & lung screening

Have you ever been diagnosed with a heart condition or stroke, or do you experience chest pain or unreasonable leg pain during exercise?

Yes No

Is your blood pressure over 200/110 mm/Hg?

Yes No Not sure

Have you been diagnosed with pulmonary (lung) disease?

Yes No

If any heart or lung conditions apply, we'll proceed only under guidance from your medical professional — your safety always comes first.

General health & lifestyle

Do any of the following apply to you?

Father or brother under 55 with history of heart disease or stroke Mother or sister under 65 with history of heart disease or stroke Aged over 55 Currently smoke, or quit within the last 6 months Blood pressure over 140/90, or on blood-pressure medication Currently mostly sedentary BMI over 30, or waist ÷ height ratio above 0.6 Blood lipids identified outside recommended range Diagnosed Type 1 or Type 2 diabetes

If two or more of these apply, we'll simply proceed with a little extra care and guidance — it doesn't mean you can't train.

Your medical provider (optional)

Doctor's name

Medical centre

Informed consent

Type your full name as your signature

Today's date

Your answers are private and used only to design your training safely. See the Privacy Policy.