Supported Fitness Sessions Sign Up Form

Personal details

Full name

UCL Email

Which best describes your student status?

- Select -

Do you identify as disabled?

Have you used a gym before?

Have you spoken to a GP or Physiotherapist about exercise?

Would you like a staff member to help you find the gym before your first session?

Pre-programme questionnaire

We use the Short Warwick–Edinburgh Mental Well-being Scale (SWEMWBS), alongside a post-programme feedback form, to assess the impact of the Supported Fitness Sessions programme. Please answer the below question.

Below are some statements about feelings and thoughts. Please tick the box that best describes your experience of each over the last 2 weeks. 1 is strongly disagree, and 5 is strongly agree.

Questions	1	2	3	4	5
I've been feeling optimistic about the future	1	2	3	4	5
I've been feeling useful	1	2	3	4	5
I've been feeling relaxed	1	2	3	4	5
I've been dealing with problems well	1	2	3	4	5
I've been thinking clearly	1	2	3	4	5
I've been feeling close to other people	1	2	3	4	5
I've been able to make up my own mind about things	1	2	3	4	5

Next steps

Please suggest some days and times for your check in (excluding weekends), and if you would prefer a Microsoft Teams or in person meeting.

Do you want to tell staff or the Fitness Instructors anything before your check in?