Fitness Client Intake Form
Client Name
First Name
Last Name
Birth Date
-
Month
-
Day
Year
Date
Phone Number
Email
example@example.com
Please state any current/previous injuries.
How would you rate your nutrition?
Poor
0
1
2
3
4
Excellent
5
0 is Poor, 5 is Excellent
How often can you exercise per week?
Please select the best days you can exercise.
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Please select the best times you can exercise.
Early Mornings
Mornings
Early Afternoons
Afternoons
Evenings
What are your training goals?
Development of muscles
Reducing the stress
Losing body fat
Increasing the motivation
Training for an event/specific sports
Other
Submit
Should be Empty: