Weekly Check-In Template for Senior Fitness Coaches

Use in FirstRep form

Personal Information

Collecting basic personal details helps tailor fitness programs to individual needs.

Aa Name *

Enter your full name

# Age *

Enter your age

Aa Contact Information *

Enter your email or phone number

Health Status

Understanding health conditions is crucial for safe exercise programming.

vv Do you have any chronic conditions? *

... Current Medications

List any medications you are currently taking

... Doctor's Recommendations

Enter any exercise recommendations from your doctor

Fitness Goals

Setting clear goals helps in tracking progress and maintaining motivation.

... What are your fitness goals? *

Describe your fitness goals

v Preferred Exercise Type *

# Exercise Frequency *

How many days per week do you plan to exercise?

Weekly Progress

Tracking weekly progress can help identify patterns and areas for improvement.

... Weekly Exercise Log *

Describe your workouts for the week

1-10 Energy Levels After Exercise *

Rate your energy levels

... Any Challenges Faced?

List any challenges you encountered this week

Safety Concerns

Addressing safety concerns is vital for preventing falls and injuries.

Y/N Have you experienced any falls recently? *

Y/N Do you feel stable during exercises? *

Aa Emergency Contact *

Enter the name and number of an emergency contact

Communication with Healthcare Providers

Effective communication with healthcare providers is essential for safe exercise.

D Date of Last Doctor Visit *

... Notes from Doctor

Summarize any relevant notes from your doctor

... Questions for Your Doctor

List any questions you have for your healthcare provider

Why Use This Template

Promotes Accountability

Regular check-ins help clients stay committed to their fitness goals.

Enhances Safety

Identifying safety concerns can prevent injuries and falls among seniors.

How to Use

Have your clients fill out this check-in form each week to monitor their progress.

Review the responses to adjust fitness plans as needed.

Customization Tips

Adjust field labels to better suit your coaching style.
Include additional health conditions relevant to your audience.
Add a section for caregiver input if applicable.

Build and send senior fitness templates digitally with FirstRep. Free for up to 3 clients.

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Frequently Asked Questions

How often should seniors exercise?

Seniors should aim for at least 150 minutes of moderate-intensity aerobic activity each week, along with strength training on two or more days.

What should I do if I feel pain while exercising?

Stop the activity immediately and consult with a healthcare provider before continuing.