New Client Intake
Please carefully read each question and answer accordingly. This form is designed to help your trainer provide the best programming possible for each individual.
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Email *
Legal Name *
Pronouns *
Date of Birth *
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Phone Number *
Address *
Height (ft'inches) *
Weight (lbs) *
Contact Preference *
Medical History
Please answer the following questions truthfully and with as much detail as could be helpful to your programming.
Have you been diagnosed with any heart conditions, high blood pressure, chronic medical conditions or bone/joint/soft tissue problems? *
Required
If yes, what? *
Do you feel pain in your chest when you do physical activity? *
Required
Do you experience dizziness or loss of consciousness? *
Required
If yes, when? *
What medications are you currently taking? *
Has your doctor said you should only do medically supervised activities? *
Required
Do you experience regular migraines? *
Required
If yes, does exercise trigger a migraine?
Do you have any physical limitations that I should be aware of? *
Fitness History & Goals
The following questions are designed to set you up for long term success, so please take the time to self-reflect before you answer the questions. 
What is your current activity level? *
Required
What are your current exercise habits? *
How many steps do you average daily? *
What are your broad goals for your fitness journey? *
Required
In your own words - be more specific. What is a measurable goal and attainable goal for your fitness journey? *
What are some obstacles that would prevent daily physical activity in your life? *
How committed are you to adding fitness into your regular schedule? *
What type of exercise do you prefer? *
Required
How many days per week can you commit to 30-60 minutes of exercise? *
Do you play recreational sports? *
If yes, during what season and how many times per week? *
What type of exercise have you done in the past? *
Have you been consistent with exercise in the past? *
How many times a day do you usually eat? *
How much water do you drink in a day? *
Choose 3 habits you could implement in your daily life *
Required
Training Package
This 12 week program is customized and tailored to your specific fitness goals and activity level. It includes regular check ins, updates, adjustments and in-person sessions as needed for form checks and support. 
I am here to support, motivated and encourage you while celebrating your achievements. I will integrate my holistic approach to health & fitness into your life through workouts, planning suggestions and recommendations, recipe sharing and food swaps/recommendations.
I focus on body recomposition, balance & stability while using load bearing exercises to build and maintain muscle mass AND bone mass so that we continue to age gracefully and with strength. 
Remote Coaching
Waiver & Consent
To begin your program you must carefully read the following and agree to the terms below.
I understand that it is my responsibility to consult with a healthcare professional prior to commencing a new fitness regime and to inform the fitness coach of any medical history or limitations that may affect my ability to perform safely in these activities. *
Required
I understand the risks associated with physical activity and agree to follow all instructions given by the Fitness Coach. *
Required
I hereby release, discharge and hold harmless the Fitness Coach from any and all claims of liabilities, actions, demands, expenses, fees and injuries that may occur as a result of my participation in fitness coaching, programming and training activities. *
Required
In taking part in personal training, group fitness and/or fitness training with Leah McCormick ~ Fitness Coach, I understand and acknowledge that I am fully responsible for any and all risks, injuries and damages which might occur as a result of my participation. *
Required
I have carefully read and understand all parts of this liability waiver. *
Required
I understand that modifying scheduled appointments requires notice at least 24 hours prior to avoid a 50% cancellation fee. *
Required
Printing your name acts as consent to begin training with Leah McCormick ~ Fitness Coach, and signals your agreement to all the terms above. *
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