Training Client Intake
Online and In-Person
Email address *
Name *
Age *
Height and Weight
Bodyfat % (if known)
General Physical Preparedness (GPP) Questionnaire
Basically, would a doctor yell at me for programming /training you?
Has your doctor ever said that you have a heart condition and/or that you should consult your doctor before any physical activity? *
Do you feel pain in your chest when performing physical activity? *
Do you lose your balance as a result of dizziness? *
Are you currently on any blood pressure medication? *
Do you know of any other reason why you should not participate in physical activity? *
Have you been diagnosed with a chronic disease, such as coronary heart/artery disease, hypertension, diabetes, etc? *
If yes to the above, please explain:
Training History
Let me know your recent times/PRs where applicable. Don't worry about hitting every single one.
1 mile time
5k Time
10k Time
13.1 Time
26.2 Time
Farthest Distance Run
Squat 1RM
Bench 1RM
Deadlift 1RM
Months/Years Running
Months/Years Powerlifting
Current/Previous other sports
Describe your current training schedule/routine
Medical/Injury
List any current/recent injuries
List any surgeries (except when you got your wisdom teeth out)
List any other relevant medical information
Diet/Lifestyle
Describe a typical TRAINING DAY of eating
Describe a typical REST DAY of eating
How much caffeine do you consume daily?
How many hours of sleep do you get each night on average?
Rate your typical sleep quality
Terrible, feel awful every day
Amazing, feel like a superhuman every day
Clear selection
Describe what you do for a living
Tell me about what you do for fun outside of training
GOALS
the fun part
Tell me what you want to achieve, both long and short term. Go nuts here. *
A copy of your responses will be emailed to the address you provided.
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