6 Week Workout

Nevada's First and Only Indoor Boot Camp Fitness Center!

All Ages - All Fitness Levels - On-Site Child Care - Morning and Evening Classes!

3691 S. Carson St., Carson City, NV 89701

HOME
BOOT CAMPS/CLASSES
SCHEDULE
PRICING
CONTACT US
6WW IN THE NEWS
FITNESS ARTICLES
TESTIMONIALS
THE TRAINERS


Corporate Accounts

CTRH
Costco
Marriott
Harley Davidson
Carson High School

Nationally Certified by

6weekworkout.com

6weekworkout.com

6weekworkout.com

6weekworkout.com

6weekworkout.com

Please be sure to fill out all (*required) information 

E-mail Address: *
Name: *
Gender: * Male
Female
Date of birth- MM/DD/YYYY *
Height: *
Weight: *
Number of hours worked per week: * Less than 20
21-40
41-60
over 60
More than 25% of your daily time at your job is spent: * Sitting
Lifting loads
standing
Walking
Driving
Date of last medical physical exam:
CHECK MARK all prescribed medicine taken in last 6 months: Blood thinner
diabetic
digitalis
diuretic
Epilepsy Medication
Heart rhythm medication
High BP medication
Insulin
Nitroglycerin
Other (specify below)
other (specify)
Please list any orthopedic conditions. Include any injuries in the last six months:
CHECK MARK any symptoms that occur 2 or more times per month: Cough up blood
abdominal pain
low back pain
leg pain
arm or shoulder pain
chest pain
swollen joints
feeling faint
dizziness
breathless from slight exertion
palpation or fast heart beat
unusual fatigue with normal activity
Other (specify below)
other (specify)
CHECK MARK any of the following for which you have been diagnosed or treated by a physician or health professional: alcoholism
anemia, sickle cell
anemia, other
asthma
back strain
bleeding trait
bronchitis, chronic
stroke
thyroid problem
ulcer
congenital defect
diabetes
emphysema
epilepsy
eye problems
gout
hearing loss
heart problems
caner
cirrhosis
concussion
hyperlipidemia
kidney problem
mental illness
neck strain
obesity
phlebitis
rheumatoid arthritis
stress
high blood pressure
HIV
hypoglycemia
Other (specify below)
other (specify)
CHECK MARK any surgeries you have had: back (spine)
neck (spine)
heart
kidney
eyes
joints
ears
hernia
lung
Other (specify below)
other (specify)
Do you exercise regularly? (Check box if YES)
How many days a week do you accumulate 30 minutes of moderate activity? *
How many days per week do you normally spend at least 20 minutes in vigorous exercise? *
What activities do you engage in at least once a week:
Phone #:
Personal Trainer Choice #1? *  (View  Bios and Videos HERE)
Personal Trainer Choice #2? *
What Package are you choosing? *
How did you hear about us?
I have read, and agree to the terms of the Informed Consent *
* Required

HOME I BOOT CAMP I CLASSES I TRAINERS I ARTICLES I NEWS I TESTIMONIALS I CORPORATE PACKAGES I CONTACT

6 Week Workout, LLC 3691 S. Carson St., Carson City, NV 89701

♦SITE DESIGN BY COMMERCIALMAKER