Full Client Check In Form

Client Check In Form

Please fill out below questions as accurately as possible. Ensure you have uploaded PICTURES to my app.
I acknowledge my check in is to be completed on Thursday. Failure to do so could result in no changes being made to my plans this week. Please still send if late. I will not send out reminders, YOU are responsible to send me your check in.
Name

First NameLast Name
What is your main goal?

Other
Program Accuracy
I need to know if you are following the prescribed plan or how close you are to reaching 100% Once again please be honest so I can make the most accurate adjustments. Please leave notes in the appropriate location about any concerns, troubles, and/or successes.
What was your training accuracy and overall performance? (Consistency, Intensity and Quality)
What is your prescribed cardiovascular protocol?
Are you doing any other training or activities outside what I have described? I.E. Sports, group cardio classes ect.
What is your average step count for the week?
How was your nutrition accuracy?
List all supplements you are taking with dosage.
List all medications you are on with dosage and how long you've been taking.
What PEDs are you currently taking and how long have you been on them? If applicable.
What was your fasted blood glucose level this morning?
How many ounces of water are you drinking in a day.
Have you tried any new foods? If you have how did your body respond?
What is your current assigned calorie and macronutrients? Training days, Recovery days and specialty days if applicable.
Date of last cheat meal or specialty day?

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
If you were assigned a cheat meal or specialty day, what did you eat and how did your body respond?
Morning fasted weight the day after cheat meal or specialty day
Only required if asked
Morning fasted weight the second day after cheat meal or specialty day
Only required if asked
How would you rate your day to day recovery?

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1 is Not Great, 10 is Great
How are your active rest days? Do you need more specific strategies for recovery?
Do you feel challenged by your training program?
Celebrate yourself and your hard work!
Name something since last check in that you are proud of yourself for or personal wins since last check in. Please elaborate.
What is a personal goal before next check in?
*This does not have to be fitness related if you don't want it to be
Wellness
How is your appetite? Do you need strategies to help?
How is your digestion? (Bloating, gas, irregular bowel movements, constipation or heartburn) Please note if you think you know what caused it.
Rate you daily average energy level.

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1 is Very Low, 10 is Very High
How many hours sleep on average are you getting?
What has been the quality of your sleep?

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1 is Poor, 6 is Great
Rate your stress level.

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1 is At Breaking Point, 10 is Nothing Bothering Me
Are there any life stressors that may have affected your results this week?
You do not have to explain yourself, however I am here to listen if you need it.
FEMALES: Where are you in your menstrual cycle? How many days until menstrual cycle is due (if known)?
Body Composition Measurements
For the following measurements use a fabric tape measure or body tape measure. (Either can be found for 1-5 dollars) Please measure the same exact spot each check in. Shoulders (both arms down at your side, at the widest point from shoulder to shoulder). Flexed Bicep (Measure the peak or center of the bicep) (left or right, but pick the same spot on your thigh each check in). Waist (at the navel line). Hips (measure the widest part of your hips). Thigh (measure the widest part of your thigh or the center between your knee and hip) (left or right, but pick the same spot on your thigh each check in).
Fasted weight this morning
Fasted weight last check in
Shoulders
Bicep
Waist
Hips
Thigh
Look for an email by Sunday for your response and adjustments.
Please address any questions, concerns or anything you would like to discuss here.
How would you rate working with me at this time?
Please tell me how I could help you better.
Signature
THANK YOU FOR YOUR CHECK IN
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Client Check In Form

Program Accuracy

Celebrate yourself and your hard work!

Wellness

Body Composition Measurements

Look for an email by Sunday for your response and adjustments.

THANK YOU FOR YOUR CHECK IN