Join Us – NutriFit of Chicago

Join NutriFit of Chicago –
Start Your Transformation Today

Your fitness journey starts with understanding your body.
Let’s create a customized plan just for you.

Join NutriFit of Chicago –
Start Your Transformation Today

Your fitness journey starts with understanding your body.
Let’s create a customized plan just for you.

WHY JOIN US

Personalized Training Programs

Tailored workouts designed
for your goals.

Certified Trainers

Professional guidance for proper
form & results.

Safe & Inclusive

We adapt training based on your health conditions.

Join us

Join Us

Personal Information

First Name

Last Name

Email

Date of Birth

Gender

Fitness Goal

Preferred Training Style

ADDITIONAL QUESTIONS

Are you currently on medication?

Yes

No

Name of medication if yes

Have you been advised by a doctor not to exercise?

Yes

No

Do you smoke?

Yes

No

How active are you?

Sedentary

Light

Moderate

High

Physician’s Name

Physician’s Contact Number

Physician’s Clearance Letter Upload

Choose File

Medical History

Medical Conditions

Any other condition

Medications

List any medications you are currently taking

Health & Medical Information

Health Conditions (Please check all that apply)

This helps us create a safe and effective workout plan.

A. Musculoskeletal Conditions

Back Pain

Neck Pain

Herniated Disc

Scoliosis

Rheumatoid Arthritis

Joint Pain (Knee/Shoulder/Hip)

Muscle Strain

Ligament Injury

Tendonitis

B. Cardiovascular Conditions

Hypertension (High Blood Pressure)

Hypotension (Low Blood Pressure)

Heart Disease

Arrhythmia

Coronary Artery Disease

Stroke History

Peripheral Artery Disease

Varicose Veins

Varicose Veins

High Cholesterol

C. Respiratory Conditions

Asthma

COPD

Breathing Problems

Allergies (Respiratory)

Sleep Apnea

D. Metabolic & Endocrine

Diabetes Type 1

Diabetes Type 2

Thyroid Disorders

Metabolic Syndrome

Obesity

E. Neurological Conditions

Migraines

Epilepsy

Multiple Sclerosis

Parkinson’s Disease

Stroke-Related Impairment

F. Digestive Conditions

Acid Reflux (GERD)

Irritable Bowel Syndrome (IBS)

Crohn’s Disease

Ulcerative Colitis

Food Allergies / Intolerance

G. Psychological / Emotional Health

Anxiety

Depression

PTSD

Stress-Related Conditions

Sleep Disorders

H. Other Conditions

Osteoporosis

Pregnancy

Recent Surgery

Autoimmune Disorders

Chronic Pain

Any other ailments that weren't listed

Liability Release

Liability Waiver Statement

I understand and agree that I will not hold my trainer or NutriFit of Chicago liable for any injuries that occur during or after training sessions.

Signature

Sign Here

Date

Additional Notes

Anything else we should know?

Address

126 E Wing St, Ste 280, Arlington Heights, IL 60004

Email

Nutrifitofchicago1@gmail.com

Phone

(847) 322-8705

©(2025) All Rights Reserved

Home
About Us
Services
Join Us
Book Now

Home
About Us
Services
Join Us
Book Now