Pre-Assessment Application | MS Fitness & Health

Step 1

Welcome to the Pre-Assessment Application

This confidential intake helps Margarita better understand your goals, training experience, body history, lifestyle, recovery, current limitations and the type of support you may need.

The purpose is to understand your starting point clearly enough to make the next recommendation thoughtful, specific and appropriate for your body.

This is not a medical diagnosis, medical consultation, or treatment plan. The information you provide allows Margarita to evaluate whether her services are appropriate for you, how to approach your training responsibly, and whether medical clearance may be recommended before beginning physical training.

The goal is not to place you into generic workouts, but to begin a thoughtful system based on your body, movement patterns, lifestyle and goals.

You do not need perfect answers. Honest context is more useful than polished answers.

After submitting this application, you can request a consultation call so your goals, background and next step can be reviewed with care.

After that review, you may be invited to schedule a 45-minute in-person Body Intelligence Assessment.

Assessment before intensity. Strategy before training. Your body first.

Step 2

Contact Information

1. First name Last name 2. Date of birth Age 3. Email address 4. Phone number

5. Best way to contact you Phone call Email

6. Are you available for in-person training in the professional training environment? Yes, I am available for in-person training in the professional training environment I need to confirm the training environment first I am not sure yet

Step 3

Basic Body Information

7. Current weight 8. Height 9. Body weight six months ago

Step 4

Main Reason for Applying

Step 5

Current Health and Safety Screening

The following questions help Margarita understand whether training can be started safely, whether adjustments may be needed, or whether medical clearance may be recommended before beginning.

12. Are you currently cleared by your doctor to exercise? Yes Yes, with some limitations I am not sure No

13. Do you know your normal blood pressure? If yes, specify it: 14. Do you know your resting pulse? If not, measure it after waking up without getting out of bed:

Step 6

Health History

15. Have you experienced these conditions in the past or recently?YesNoOther

Digestive system disorders

Cardiac catheterization, coronary angioplasty, heart surgery, myocardial infarction

Cardiac arrhythmias, pacemaker / implantable cardiac defibrillator

Stroke

Diabetes

Inborn heart defects, pathology of heart valves, heart failure

Liver diseases

Cancer

Respiratory system disorders

High blood pressure

Thyroid gland malfunction

Genitourinary system disorders

Vascular diseases including varicose veins / hemorrhoids

Surgical intervention in the past 12 months

Pregnancy at the moment or within the past year

Hernias, protrusions or other conditions of the spinal column that require additional attention

Muscles or joints malfunction

16. Comments to the questions above, if necessary: 17. Have you had any injuries or surgeries? If so, which ones and when? 18. Are you currently taking medications? If yes, specify which ones: 19. Do you have any diseases, diagnoses, limitations, or important health information not mentioned in this questionnaire? If yes, specify which ones: 20. Are there any movements, exercises, positions, or loads you are afraid to do or have been told to avoid? 21. Are there any points not mentioned in the questionnaire that may cause difficulties during training or physical fitness tests? If yes, specify below:

Step 7

Pain, Discomfort and Movement Limitations

22. Do you currently experience pain, stiffness, discomfort, or movement limitations? Yes Sometimes No I am not sure

24. Please describe the discomfort, limitation, or pain in your own words: Include when it appears, what makes it worse, what makes it better, and whether it affects training or daily life.

Step 8

Training History

25. How would you describe your current fitness level? Beginner Returning after a long break Intermediate Advanced I am active, but I do not have a clear system I am not sure

26. Have you had any fitness or sport-related activities in the past, such as sports, fitness, dancing, yoga, etc.? If so, what and when? 27. Do you currently have classes related to physical activity, such as sports, fitness, dancing, yoga, etc.? If yes, specify which ones and indicate how long you have been training:

28. Have you worked with a personal trainer before? Yes, and it was a good experience Yes, but it did not work well for me Yes, but I felt unsafe or misunderstood No, this would be my first time I have trained in groups only

30. Specify your normal physical activity level: < 2 classes per week, classes are irregular, minor to moderate activity 2-3 classes a week, classes are fairly regular, moderate to significant activity ≥ 3 classes per week, regular classes, significant to extreme activity

31. Within the last 3 months, have you had regular workouts lasting for at least 30 minutes, with moderate intensity and a frequency of at least 3 times a week? Yes No

Step 9

Recovery, Stress and Lifestyle

32. Are there any signs that allow you to suspect under-recovery or overtraining?

No Prolonged fatigue Feeling of morning fatigue after training Decreased performance Irritability or mood swings Strong reluctance to train Sleep disorders Other

33. Are there any features of your work and rest regime that can affect physical endurance and recovery after training sessions?

No Shift / irregular working day High overload at work Inability to have proper sleep Problems with regular meals High stress Frequent travel Family / childcare responsibilities Other

35. Do you use nervous system stimulants?

No Coffee Energy drinks Cigarettes Other

Step 10

Nutrition

36. Do you follow any diet? If so, which one?

37. How would you describe your current nutrition?

Structured and consistent Mostly healthy, but inconsistent Emotional eating / stress eating is an issue I struggle with sweets or cravings I often skip meals I have tried many diets I need a simple system I do not understand what works for my body Other

Step 11

Time Commitment and Preferences

38. How many times per week would you ideally like to train? 1 time per week 2 times per week 3 times per week 4+ times per week I need Margarita's recommendation

39. What time of day usually works best for you?

Midday Afternoon Evening My schedule changes, and I need help finding the right schedule

40. Are there any types of physical activity or exercises that you particularly enjoy? If so, which ones? 41. Are there any types of training, exercises, or activities you strongly dislike or prefer to avoid?

Step 12

Goals

Evaluate each goal according to the degree of importance for you on a scale from 1 to 10, where 1 is "not important at all" and 10 is "very important".

57. It is also very important to me:

Step 13

Support Level and Program Fit

58. What kind of support are you looking for?

Intelligent start A structured transformation plan Corrective exercise and movement guidance Strength training with proper technique Posture and mobility support Nutrition and habit guidance High accountability and close support Full expert guidance with a personalized strategy I need Margarita's recommendation

59. Which program level are you most interested in? FOUNDATION - Intelligent start PRECISION - Enhanced support SIGNATURE INTENSIVE - High-touch coaching I am not sure yet and want a recommendation

60. How soon would you like to start? As soon as possible Within 1-2 weeks This month I am researching options I am not sure yet

Step 14

Final Notes

61. Is there anything else Margarita should know before your consultation call?

Before submitting

By submitting this application, you understand that this questionnaire does not replace medical advice, diagnosis, or treatment. Margarita may recommend medical clearance before training if needed. The information you provide should be accurate to the best of your knowledge.

Liability, Consent & Scope Acknowledgment

Before submitting, please review and acknowledge the training scope, voluntary participation, and liability terms.

Open waiver in a separate page

Liability Waiver, Informed Consent, Assumption of Risk, and Training Scope Acknowledgment

Version: Liability Waiver v1.0 · May 2026

Participation in personal training, corrective exercise, movement coaching, mobility work, strength training, nutrition education, and related wellness guidance with Margarita / MS Fitness & Health is voluntary.

The client understands that physical activity may involve risk, including muscle soreness, fatigue, discomfort, aggravation of a prior condition, fall risk, or other injury. The client accepts responsibility for choosing to participate and for communicating honestly about current health, movement history, symptoms, limitations, medications, injuries, surgeries, pregnancy status, and any changes in health status.

MS Fitness & Health provides fitness coaching, movement education, corrective exercise guidance, strength programming, mobility guidance, accountability, and general nutrition education. These services are not medical diagnosis, medical treatment, physical therapy, psychotherapy, emergency care, or medical nutrition therapy.

The client understands that results are not guaranteed. Training recommendations are based on the information provided by the client, observed movement, professional judgment, and the client's response to exercise.

The client agrees to stop and inform Margarita if pain, dizziness, shortness of breath, unusual symptoms, sudden discomfort, or concern occurs. Medical clearance may be recommended when appropriate. Nutrition guidance is educational and does not replace care from a physician, registered dietitian, or licensed medical provider.

To the extent permitted by applicable law, the client acknowledges and assumes the ordinary risks associated with voluntary fitness participation and releases MS Fitness & Health and Margarita from liability arising from participation, except where prohibited by law.

This acknowledgment does not include media or photo consent. Any media permission should be handled separately. This document is not a substitute for attorney review.

Your body deserves to be understood before it is asked for more.

Body-first approach

Careful screening before intensity

Personalized recommendation

Pre-Assessment Questionnaire

Before you begin

Welcome to the Pre-Assessment Application

Contact Information

Basic Body Information

Main Reason for Applying

Current Health and Safety Screening

Health History

Pain, Discomfort and Movement Limitations

Training History

Recovery, Stress and Lifestyle

Nutrition

Time Commitment and Preferences

Goals

Support Level and Program Fit

Final Notes

Liability, Consent & Scope Acknowledgment

Liability Waiver, Informed Consent, Assumption of Risk, and Training Scope Acknowledgment

Your application has been submitted.

Schedule your Consultation Call

Your Initial Consultation Call has been scheduled through Calendly.