Personal Physical Fitness Plan (Page 4 of 10) in pdf

Personal Physical Fitness Plan Page 4

Personal Fitness Questionnaire (Continued)

8. List your “problem” body areas where you think you are over fat, over or under developed.

These are areas that you would put some focus on if you had the chance to start a program.

_____________________________________________________________

9. What are your fitness goals? Mark all that apply.

Appearance

Cardiovascular endurance

Reduce body fat

Get more flexible

General Health

Muscular definition

Muscle size

Muscle strength

Self-esteem or confidence

Speed

Sports Performance

Reduce my stress level

Tone and shape my body

Lose weight

Improve posture

Medical reasons

Other____________________________________________________________________

10. Where do you perform most of your fitness activities?

Home

Outside

Fitness Facility (gym, health club, pool, etc.)

11. What equipment do you have available on a regular basis?

Nothing

Free Weights (dumbbells, etc.)

Weight machines

Treadmill or other home machines

Resistance balls or other core home equipment

Exercise Videos

Jump Ropes

Bicycle, Skateboards, Roller Blades, other

Other: ____________________________________________________

12. What time of day can you do most of your exercise?

Any time

Morning

Afternoon

Evening

13. Which of the following are your personal obstacles in adopting a regular fitness program?

I get bored pretty easily when I exercise

Intimidated and embarrassed when I exercise

I can’t really find the time to exercise

I have to exercise alone

Family obligations

My exercise setting does not meet my needs

I get frustrated because I don’t see results

I do not have personal obstacles, I am just lazy

right away

Other: _______________________________

14. How would you rate your overall fitness?

Pg 3 & 4

Excellent

Above Average

Average

Rubric Score

Needs a lot of improvement

Not fit at all

__________

Personal Physical Fitness Plan Page 4

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