Client Intake Form
Basic information about your health, lifestyle and physical experience
What inspired you to join the movement?
favorite ways to move your body?
Something you dream of accomplishing?
Do you have a regular physican? Are you cleared for exercise?
Are you currently on any Medications?
Current pain level?
Have you had any surgeries? if so please include date (s)
Injuries in the Past, please list. Current injuries with dates.
Physical Activities you enjoy?
Do you cook for yourself? If so how many times a week?
Where do you buy food?
How much water do you consume daily?
What are your fitness Goals?
Best way to contact you? Include email and phone
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