Client Intake Form for Coaching Inquiry  
Welcome! This intake form gathers essential information about your health, fitness experience, and goals. Your responses will help determine if my coaching program is the right fit for you and allow me to tailor a plan that supports your journey to lasting health, happiness, and success.
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Basic Information
Full Name
Email
Phone Number
Gender
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Health & Medical Background 
Do you have any pre-existing medical conditions? (Yes/No) If yes, please specify
Do you have a family history of any medical conditions? (Yes/No) If yes, please specify.
Do you have any previous injuries or current pains that impact your training? (Yes/No) If yes, please specify.
Fitness Goals & Experience 
What are your primary fitness goals? (e.g., fat loss, muscle gain, strength, endurance, general health)
What do you currently weigh? (lbs)
What is your height? (feet/inches)
How would you rate your gym experience? (Beginner / Intermediate / Advanced)
What does your current workout routine look like? (If applicable)
What has stopped you from reaching your fitness goals in the past?
Lifestyle & Training Preferences
What do you do for work? (Understanding stress levels & movement)
How active is your job? (Sedentary / Lightly Active / Moderately Active / Very Active)
Are you interested in: 
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If in-person training, are you able to commute to HeatRaleigh? (Yes/No)
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How many days per week can you commit to training? (1-2, 3-4, 5+)
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Do you have access to a gym for training? (Yes/No)
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Coaching Expectations & Commitment
What are you looking for in a coach? (Motivation, accountability, structured programs, etc.)
Are you ready to commit to an 8-week coaching program? (Yes/No)
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How did you hear about me? (Instagram, Referral, Gym, etc.)
Anything else you’d like me to know about you?
Coaching Services

What You Get with My Coaching:
I offer customized training programs designed to fit your specific goals, experience level, and lifestyle. Whether you’re training in-person or online, you’ll receive:

✅ Tailored Workout Program – A structured training plan designed for your goals, updated every 4 weeks.
✅ Weekly Check-Ins – A questionnaire to track progress, discuss challenges, and make adjustments.
✅ 24/7 Access to Me – Unlimited messaging for questions, support, and guidance.
✅ Nutritional Guidance – Tips and recommendations to complement your training for maximum results.
✅ Accountability & Motivation – Direct coaching to keep you on track and progressing consistently.

How It Works:

  • In-Person Training: 1-on-1 or small group coaching at HeatRaleigh with hands-on instruction.
  • Online Coaching: Fully remote programming with regular check-ins, video analysis, and constant support.

💥 Ready to Get Started? Once you submit this form, I’ll review your information and reach out to discuss the next steps!

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