Client Intake Form

Client Intake Form

First and foremost I want to thank you for taking interest in joining Team Die Trying! Please be sure to fill out this form in it's entirety and include a current email as we will contact you via email
Name

First NameLast Name
Email
example@example.com
Phone Number
Instagram Handle
Age
Height
Weight
What Is Your Main Fitness Goal?

Losing Body FatGain Muscle/StrengthBuild A Better Relationship With FoodCompete In A Show One DayCompete/Improve Placing (Competed Previously)
What Is Your Timeline To Achieving Your Goal?

0-3 Months3-6 Months6-12 Months12+ Months
What does a normal day of eating look like? (List Meal Plan or Macros if applicable)
How many days per week are you working out? And what facility access do you have? (Commercial Gym, Apartment Gym, etc.)
Have you ever worked with a coach? If you have, how would you describe your experience?
Which Coach Are You Interested In Working With?

Christopher Perry (IG: Cp.Legs) Owner/FounderRiley Orrico (IG: rileyorricoo) Assistant CoachNo Preference
How Did You Hear About Us?

InstagramWebsiteFriend/Family Member
How dedicated are you on a scale 1-10?

1

2

3

4

5

6

7

8

9

10

1 is Unmotivated, 10 is I'll Do Whatever It Takes To Be Improve
List any other information that you think will be helpful to me:
Preferred Start Date:
File Upload

Please include recent physique update pictures here
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