Medical Clearance Form
Previous Metabolic Typing Recommendations
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Verify PTAs
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Verify Training Sessions
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Verify Payment Vouchers
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Verify Assessments
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Master Claim Form
Pinnacle Fitness Master Claim Form | |||||||
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Master Claim Form | |||||||
PT Claims | |||||||
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Introductory Reports
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Mid Assessment Reports
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Fitness Appraisal Reports
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Dietary Review Reports
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Users List
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Locations List
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Programs List
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Clients' Goals List
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Clients List
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Add New Client
Personal Information
Training Guidelines
Payment Voucher
Training Log
No | Date | Program | Duration | Calories | Avg HR | Trainer | Remarks |
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Update Client Profile
New Metabolic Typing Questionnaire
Previous Metabolic Typing Questionnairies
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New Metabolic Burn Chart
Previous Metabolic Burn Charts
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New Introductory Report
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New Assessment Report
Previous Assessment Reports
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Edit Dietary Review
Type | Recommendation | Actual | Benefits |
Daily Calorie Intake | |||
Carbohydrates | Less than % | % | |
Fat | Less than % | % | |
Protein | More than % | % | |
Cholesterol | mg | mg | |
Sodium | Less than 1500mg | mg | |
Sugars | Less than 40g | g | |
Fibre | At least g | g |
New Dietary Review
Type | Recommendation | Actual | Benefits |
Daily Calorie Intake | |||
Carbohydrates | Less than % | % | |
Fat | Less than % | % | |
Protein | More than % | % | |
Cholesterol | mg | mg | |
Sodium | Less than 1500mg | mg | |
Sugars | Less than 40g | g | |
Fibre | At least g | g |
Previous Dietary Reviews
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Upload Document
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Edit Assessment Report
Client Program
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Client Renewal
Training Guidelines
Payment Voucher
Payment Voucher
Assessment Entry
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Lean Mass (kg) | |||||
BMI | |||||
Measurements | |||||
Waist to Hip Ratio | |||||
Flexibility | Measurement | Level | Pinnacle Rating | ||
Strength/Power | Weight | Reps | 1RM | ||
Abdominal | Score | Level | Pinnacle Rating | ||
Upper Body | Score | Level | Pinnacle Rating | ||
Balance | EO | EC | |||
Cardiovascular | Min | Hr | Rating | Heart Rate | |
Cardio Score | Cardio Rating | Pinnacle Rating | |||
PINNACLE FITNESS RATING (Overall) | |||||
Edit Assessments
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Edit Individual Training Data
Individual Training
Previous Entries
Edit My Fitness Pal Data Entry
My Fitness Pal Data Entry
Previous Entries
Personal Training Agreement
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Congratulation on taking this step to improve your health & fitness.
Please tick either yes or no to each of the following questions. | Yes | No | |
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1. |
Has your doctor ever informed you that you have a heart condition and that you should only do physical activity recommended by a doctor? |
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2. | Do you feel chest pains when you do any physical activity? | ||
3. | In the past month, have you had chest pains when you were not doing any physical activity? | ||
4. | Do you lose your balance due to dizziness or do you ever lose consciousness? | ||
5. | Do you have a bone or joint problem (including your back) that could be aggravated by physical activity? | ||
6. | Has your doctor informed you that you have high blood pressure? | ||
7. | has your doctor informed you that you have high cholesterol? | ||
8. | Is your doctor currently prescribing you medication for any of the following? If yes, |
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9. | Do you have diabetes? | ||
If you have answered YES to any of the above questions, we will need a signed medical clearance letter from your doctor or specialist. Please speak with your trainer prior to commencement of your program. |
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10. | Is there a history of heart disease, stroke or high cholesterol in your family? | ||
11. | Do you or have you smoked cigarettes /cigars/pipes(previously)?
If you have answered YES or PREVIOUSLY,indicate the number of years you have been smoking: & . If previously, |
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12. | |||
13. | Do you suffer from asthma? | ||
14. | Do you or have you had a stomach or duodenal ulcer? | ||
15. | Do you or have you had a liver or kidney condition? | ||
16. | Do you suffer from epilepsy? | ||
17. | Do you have arthritis? | ||
18. | Do you have a hernia? | ||
19. | Have you been hospitalised or undergone surgery in tne past 12 months? | ||
20. | Do you drink alcohol? If you have answered YES, how many days per week do you drink alcohol? How many drinks do you consume each time? (1 standard drink is equivalent to 1 middy of full strength beer, 1 glass of wine or 1 nip of spirits.) |
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The above information has been (completed/reviewed) by me and is true and correct. Client's Signature:___________________________ Date: ______/_______/______________ |
Training Guidelines
Following is an explanation of your personal training program together with some guidelines. Please sign once you've read and understood its contents.
TRAINING GUIDELINES
- times per week.
- Physical Assessments: physical assessment(s) are scheduled with this program.
- Training Program: Your goals for training are and your program will be designed accordingly.
TERMS & CONDITIONS
- Rescheduled Appointments: Rescheduling of any PT session can be made anytime up to 9:00pm the evening before at no charge.
- Missed/Cancelled Appointments: Missed or cancelled appointments will result in forfeiture of the session.
- Late for Appointments:
- If you begin your PT session late, your PT session will still finish at the pre-designated time. You may purchase a 2nd session if you wish to continue into the next time slot.
- If your personal trainer is late by more than 10 minutes, you are entitled to a free PT session. Please contact Mark directly on 012-300-2204 directly to confirm your free session.
- Venue: All training will be conducted at .
- Schedule: Your schedule will be confirmed weekly with your trainer.
- Payment: The PT program fee is RM for () PT sessions.
- Program Expiration: Expiration of all PT programs is 6 months from date of receipt. No extensions permitted under any circumstances.
- Refunds: No refunds are possible.
MEDICAL CHECKUP
- We strongly recommend that you undergo a medical check-up with your physician prior to the commencement of any training program.
DISCLAIMER OF LIABILITY
I have completed the foregoing questionnaire and the personal trainer has answered all my questions to my satisfaction. I have informed Pinnacle Fitness Sdn Bhd (“Pinnacle”) the details of all my medical conditions, and history, as well as, all recent medical treatments received by me. I am responsible for determining my medical condition and physical fitness to take part in the personal training program and the personal trainer reserves the right to exclude me from performing some or all of the health fitness assessments based on the medical information given by me. I shall at all times hereafter save harmless and keep Pinnacle indemnified against all actions, proceedings, claims, demands, penalties, costs and expenses which may be brought or made against or incurred by Pinnacle by reason or on account of, me not disclosing my other medical information to Pinnacle and where I had been advised by Pinnacle, to consult my physician before commencing the training sessions.
I understand and acknowledge that the personal training activities involve an inherent risk of injury and have voluntarily accepted this risk. In consideration for the personal training, I hereby accept and fully assume all risks and dangers and the possibility of personal injury, death, and property damage or loss resulting from my participation in the personal training program. I shall also at all times hereafter save harmless and keep Pinnacle, its employees, and agents, from any and all claims, actions, costs, expenses and demands in respect of any injury incurred including, without limitation, personal, bodily, or mental injury, economic loss or damage to myself resulting from my participation in personal training activities and the use of the equipment or machinery in the personal training program.
Client’s Signature:___________________________
Date: ______/_______/______________
Pinnacle Fitness___________________________
Date: ______/_______/______________