Please complete the Pre-Exercise Questionnaire below to help Nathan assess your fitness & health background. This will ensure Nathan can design a program for your specific needs.


Please enter your name:
Please enter your address:
Preferred Contact Phone Number(s):
Email Address:
Date of Birth:
Gender: e

What do you wish to achieve from your exercise program (please tick all that apply):

Reduce Body Fat Stress Management Sports Conditioning
Improve Muscle Tone Rehabilitation Strength Training
Increase Endurance  Increase Muscle Mass Body Building
Weight Loss   Re-Shaping   Improve Fitness

Do you suffer from any of the following conditions (please tick all that apply):

Arthritis Heart Condition Asthma
Diabetes High/Low Blood Pressure High Cholesterol
Epilepsy Liver/Kidney Condition Heart Trouble
Bone or Joint Problems Muscle Tension  Chest Pain
Back Problems Sports Injuries Other (below)

If so, please explain:

Are you pregnant or attempting to fall pregnant? , please provide details:

Are you currently on any medication? , please provide details:

Do you smoke? , please provide details:

How many times per week do you wish to train? What are your preferred times?

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All information, articles, instruction, fitness programming and advice from nathansmith.com.au is designed to help you make informed decisions about your health and fitness. In no way should any information thereby obtained at this website be used as a substitute for your doctor’s advice or treatment. We strongly recommend consulting your doctor before beginning any exercise program. You should understand that participation in any exercise program represents the possibility of injury and agree that any information, instruction or advice obtained from nathansmith.com.au will be used at your own risk. By accepting the terms and conditions of this agreement you agree to release and discharge nathansmith.com.au from any and all responsibilities or liabilities from injury arising from your participation in any exercise program or advice obtained at this website. By clicking the following button you affirm that you have read, fully understand and agree to the above.


* It is recommended that all males over 35 and females over 40 years of age have a medical assessment prior to commencing any exercise program.

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