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Individual Nutrition and Fitness Assessment

The Individual Nutrition and Fitness Assessment has been developed to determine your past and current eating and exercise habits as they relate to your desired health and fitness goals. The purpose of this evaluation is to identify any and all dietary and exercise related deficiencies that may prevent you from efficiently achieving and maintaining your desired health and fitness goals.

Upon submitting answers to the following questions, the INTRAFITT Expert Software System will determine the current rate of your dietary and exercise efficiency. Unless your current dietary and exercise efficiency rate is 80% or above, it is strongly recommended that you register for the INTRAFITT Individualized Nutrition and Exercise Program in order to efficiently achieve and maintain your desired health and fitness goals.
Your Physical Fitness Objectives / Goals
Please indicate the order of personal importance: (1=Most Important, 4 = Least Important)
Reduce Body Fat / Increase Muscle Tone:
  1    2    3    4
Increase Lean Body Mass / Strength:
1    2    3    4
Increase Speed / Endurance:
1    2    3    4
Improve Overall Health and Condition:
1    2    3    4
   
Your Conditioning History Assessment
1) Have you ever been a member at another health facility?
  Yes:      No:
2) Have you ever worked with a fitness trainer?
  Yes:      No:
3) Have you ever been on a weight loss or weight gain diet?
  Yes:      No:
4) Have you ever taken supplements to enhance weight loss / gain?
  Yes:      No:
5) If you answered YES to any of the above questions, were you able to efficiently achieve and maintain your desired health and fitness goal(s)?
  Yes:      No:
     
Your Nutrition Assessment
1) Do you ever skip breakfast and/or find yourself snacking late in the evening?
  Yes:      No:
2) Do you ever crave sugary foods and/or lack energy?
  Yes:      No:
3) Do you ever feel tired and lethargic before, during or after exercise?
  Yes:      No:
   
Your Exercise Assessment
1) Do you monitor your heart rate
when performing cardiovascular exercise?
  Yes:      No:
2) Do you perform cardiovascular exercise in your recommended target heart rate at least 30 minutes per session, 4 times per week?
  Yes:      No:
3) Do you feel like your weight training sessions
are as productive as possible?
  Yes:      No:
 
Your Commitment
Please rate your Level of Commitment* towards Achieving Your Desired Goal:
*Commitment refers to the Amount of Time and Effort You are willing to put forth.
(1= NOT Very Committed, 4 = VERY Committed*)
*Minimum Commitment Requirements: Eating at least four (4) meals per day, and Performing at least three (3) one-hour exercise sessions each week.
1    2    3    4