New Client Intake Form
Hey! Thanks for your interest in training in person with me! All new clients are required to fill out this intake form before beginning with me. I cannot wait to get you started on reaching your goals, however spaces and availability are limited and I can only take on so many people at once. After this form has been filled out I will reach out to with my current availability and see what I can do for you!

All new clients are required to fill out this intake form before beginning with me. I cannot wait to get you started on reaching your goals, however spaces and availability are limited and I can only take on so many people at once. After this form has been filled out I will reach out to with my current availability and if I am able to accept you then we will set a brief consultation call!
What training service are you interested in? *
Required
First & last name *
Email *
Phone number *
Age *
Sex *
Job Occupation *
Does your occupation require extended periods of sitting? How many steps do you average per day?
Height (Inches) *
Current Body Weight *
Goal Body Weight *
Do you currently workout/exercise? *
If yes, for how long and what does your current routine look like? *
If yes, rate your exercise intensity *
Walk into the gym and just leave
Always giving it 110% (Can occasionally overdo it)
If no, what has been holding you back? *
Have you worked out in the past? *
Have you worked with a trainer in the past? *
What are you short and long term goal/s? *
Why are these goal/s important to you? *
How far are you from reaching these goal/s? *
Do you have any current or past injuries? Any surgeries or limitations? *
Has a medical doctor ever diagnosed you with a chronic disease, such as coronary heart disease, hypertension, high cholesterol, diabetes, etc.? If yes, please explain: *
Are you currently taking any medication? If so please list and what they are for *
Rate your ability to perform strength training exercises *
Never touched a weight
Pro lifter
Rate your ability to perform cardio exercises *
No cardio at all
Cardio all day
How many meals per day are you currently consuming? *
What does a typical breakfast, lunch, and dinner look like? *
What are your current eating weaknesses? *
How motivated are you to reach these goals? *
I'm not
Highly
Rate your accountability *
Bad
I'll never miss a session
How many days per week can you commit to working out? *
What do you feel is going to hold you back the most? *
What is going to help push you forward the most? *
When you sign up to train with me you committing to me as your trainer. With that being said, I want what is best for my clients and am here to invest my time in helping them and their health goals. You understand this and that effort must be put forth with training in order to achieve results and are ready to put forth such effort *
With macro nutrition training, you are required to record the foods that you eat in order to build a macro profile for me to go over. There are many services/apps that allow you to do this such as MyFitnessPal. Do you have an app or program in mind that you plan to use? *
Training is not only a financial commitment, but an investment in your health, requiring effort and time on both ends. When you sign up to train with me you are agreeing that you are ready to invest in not only yourself, but me as well. I expect effort to be put forth, to the best of your ability, so that we can achieve these goals without wasting time. Are you financially willing and able to make that commitment to hiring a person trainer? *
Anyone wanting to train in person, there is a strict 24 hour cancellation policy. If a cancellation is made within 24 hours of the start time, the session will be forfeited. Do you agree to this policy? *
As your trainer it's all about you and how I can help guide and teach you. Is there anything specific you would like to learn from me ? *
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