IronxEdge Coaching or Training Client Intake Form

NASM/J3U/HCU

Certified

Please select which service you are interested in: (2026 Rates)

Monthly Online Coaching for any goal including lifestyle, weight loss, general fitness, building muscle/strength, bodybuilding (all categories) etc., includes customized training program and cardio programming with adjustments as needed, complete nutrition setup with macros, meal structure or meal plan and food options with adjustments as needed, weekly check ins, exercise execution/form review, supplements protocols, PED guidance/protocols if applicable, messaging/email with support 24 hour or less response time. $225/month recurring payment or paid in full options $600/3 months, $1000/6months.

Client Name

First NameLast Name

Age

Height

Weight

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Format: (000) 000-0000.

Email

example@example.com

Emergency Contact Name

First NameLast Name

Emergency Contact Phone Number

Format: (000) 000-0000.

Have you worked with a coach previously? If so, who?

How was that experience?

If you are interested in competing, do you have any prior competition experience?

What are your short term goals?

What are your long term goals?

What is your “why”? This is what really matters and drives you when things are hard.

How important are your fitness goals in relation to other areas of your life? What challenges might you face?

What is your occupation and work/school schedule? Are you active on the job or more sedentary? How do you spend your time (lifestyle/work/children/etc)?

How much experience do you have with weight training? Have you tried programs in the past with positive results?

How many days are you currently training? How many days can you train? What is your current training split?

What is the best time of the day for you to train schedule and energy wise?

Do you have any specific aesthetic goals or body parts you want to prioritize?

How much time are you able to spend in the gym?

What equipment do you have access to? (Full gym, home gym, etc)

Do you have any injuries? Are there certain exercises that you avoid?

Are there any exercises you really enjoy and want to make sure are incorporated into your training split?

Are you currently doing cardio? If yes, what are you doing?

What type of cardio has helped you get the best results in the past?

Describe, in detail, a typical days worth of eating.

If possible break it down by meal ie meal 1, meal 2, etc.

Do you know your current macronutrient breakdown (protein, carbs, fats, calories), if so please list

How long have you been at this current intake?

Have you been experiencing weight loss or gain with this intake? How has gym performance been and energy outside of the gym?

Do you have any digestive issues? This is an important aspect that people often ignore. To get the most out of your program we need to optimize digestion as much as possible.

What foods do you love?

What foods do you hate?

Do you have any food sensitivities? Do you notice a negative response with any foods?

Would you prefer a structured meal plan or a flexible plan with daily calorie and macro targets with a suggested food list, or a very flexible and basic approach with nothing to track?

Are you on any prescribed medications?

Women only, are you on any birth control? Which? Are you having a regular menstrual cycle? What is your history with regular or irregular cycles?

How would you rate your sleep? Are you getting 7.5 hours or more a night? Any issues with trouble falling asleep, staying asleep, or waking up refreshed?

How would you rate your stress levels day to day? If you feel stress is high, do you notice oh feel more anxious at particular times of the day?

Please list any supplements you are taking

Competitors only: Are you currently or have your recently used performance enhancing drugs? If so, please list and describe experience.

Do you drink alcohol or use recreational drugs?

Competitors only: Do you have recent blood work results? If yes please email to ironxedgecoaching@gmail.com

Lastly, please tell me exactly what you want to get from your experience with me. Is there anything else I should know?

Please email me front and back and side photos in a level of clothing you are comfortable in. If you are a competitor, please hit several of your stage poses. Please take pics in a clearly lit room at a distance away that I can see your whole body in the shot. (Ironxedgecoaching@gmail.com)

I, {clientName}, hereby acknowledge that the information I've given above is complete and accurate. I understand all the risks and I accept all the responsibility for any undesired situations during training. I am informed that my information in this form will be kept confidential.

My coach has informed me that I am the only responsible party both for all the injuries during the fitness program and incorrect information. I release and discharge Brian Bourbeau, from any disclosure of my personal information in this Fitness Client Intake Form.

If any of my health, lifestyle or personal information/situation that may prevent my training is changed, I guarantee that I will inform Brian immediately.

Client Signature

Date

Online Coaching Intake Form

Release and Acknowledgement