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Client Intake Form
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Email *
First & Last Name *
Age *
Gender *
Which are you looking for?
Clear selection
Height *
Weight *
Current Occupation *
Blood Pressure (if you know) *
Are you cleared for exercise by your doctor *
Do you currently take any medications? *
Please check off any of the health conditions you have currently/recently experienced within the last 12 months *
Required
Please Explain Further *
What are your current physical goals? *
Required
Pick your top 2 priorities from above and tell me why they are most important to you *
Are there any specific performance goals you're looking to achieve?

Ex: Add 20 lbs to your bench press in 6 months, lose 10 lbs in 3 months, achieve a bodyweight pull up in a year *
Why are you looking to achieve this goal? *
What would you say has been your largest obstacle in achieving this end goal? *
What assistance are you specifically looking for to help you overcome this problem? *
How many days / week are you realistically able to train and for how long each session?
Do you have any lifestyle goals? *
Required
On average, how much sleep do you get per night? *
How would you rate your current fitness level? *
I will literally fall over if the wind blows
Fight me
How would you rate your regular nutrition & eating habits? *
I don't even think about it
Highly organized, I hit my nutrition & count macros regularly
What would you say is your average stress level from day today? *
None, I am way too relaxed
I am a complete & utter maniac
How do you spend most of your time outside of work/school? *
What would you say you lean towards *
How would your best friends describe you? *
What type of environment do you live in? *
How do you typically get around? *
Have you ever worked with a coach/trainer before? *
If yes, what did you like? What did you dislike? What was your biggest takeaway and what would you like to see different this time? *
What is your idea of a training session? *
Are you someone who needs novelty, or needs to "switch it up" regularly? *
What do you need most from me as a trainer? *
Required
In fewer than 3 sentences, what are you hoping to achieve by working with me? *
If you accomplish your goals, how different would your life be?  *
What's a low hanging form of action that you could begin taking right away?
 *
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