anamnesi - Personal Trainer Valerio Rea Elisabetta Mastrobuono

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Medical history card
General Anamnesis the fields marked with * are mandatory








Anthropometric data




Physical activity


No
Yes

why
yes, which one / s






Yes
No







meagermedigood

single
group

gym
outdoors
pool



General physiological notes

yesno


yesno


HighNormalLow

yes



no

Sleep



yesno

yesno
Feeding

Very badbadVery wellwell
Diseases

 heart thyroid allergies hepatobiliary respiratory hormonal orthopedic
 diabetes hypertension gynecological nervus digestive venous

yesno


yesno


 Back
 Shoulders
 Knees
 Ankles
 Foot
 Other

 Determined with which exams
 Determined with which exams
 Determined with which exams
 Determined with which exams
 Determined with which exams


yesno

Goal definition


For nothingShortlyQuiteVery


For nothingShortlyQuiteVery


WELL, today is the first day of a new lifestyle. Are you ready?

Elisabetta Mastrobuono
Valerio Rea


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