C5 FIT intake form
Welcome to Personalized Fitness with C5 FIT.

We place a VERY high value on our ability to meet you where you're at in your current journey, and ensure we provide you with the most beneficial Fitness program that will align with YOU, the individual, to help you achieve your desired results.

Please be as open and honest with all responses so we can have a clear understanding on where you currently sit at this phase of your journey.

Remember; Fitness is a journey, not a destination. Where you sit today, is not where you will sit in a month, or 6 months, or years. We're here to help inspire, educate, and guide you in this process of becoming the best version of yourself possible through a personalized Fitness experience.

Thank you for choosing C5!
How did you hear about us? *
First name *
Last name *
Email *
Phone *
Date of birth (MM/DD/YY) *
What are your top 3 values/priorities? (Ex: family, career, fitness/health)
What are your Fitness goals? *
What are you seeking in a Fitness facility/program? *
Why do you choose to workout? *
How many hours per week, or day, do you anticipate investing in your Fitness? *
What is your Fitness/athletic history, if any (ie: youth sports, College sports, competitive sports, weight lifting, running, swimming, cycling......etc)? *
Where do you plan to train/workout? *
What is your career? (please include; hours of work per week, sitting/standing/driving/traveling...etc, day shift/night shift, high stress, low stress, physical, sedentary....etc) *
Do you have any medical conditions we should be aware of (specific medications that could impact your; motor skills, mental clarity, emotional state, any surgeries, injuries, tweaks, strains, metal rods/plates/screws that could potential limit range of motion and/or movement mechanics....etc)? *
On a scale of 1-10, please rate your current, perceived Fitness level *
Out of shape
Elite level Fitness
On a scale of 1-10, please rate your Nutritional awareness *
Unaware of proper nutrition and food sources
VERY knowledgeable and aware, ie; you understand what macronutrients & micronutrients are, you understand the how and why, the body metabolizes them and uses them all for fuel.
On a scale of 1-10, please rate your Nutritional practice *
Excellent/On point/Dialed in
On a scale of 1-10, please rate your hydration practice *
Poor (less than 50% of my bodyweight in ounces per day)
Excellent (60% or more than my bodyweight in ounces per day)
How many ounces of water do you drink per day (on average)?
Tell us about your sleep habits *
Do you have a promo code?
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