Simple Strength Coaching Intake Form

1
Name* This field is required.
First Name
Last Name
2
E-mail* This field is required.
example@example.com
3
Phone Number* This field is required.
4
Preferred method of contact* This field is required.
Text
Email
Either
5
What are your fitness goals?* This field is required.(What is your reason for getting into fitness?)
Ex. “Gain strength”, “Lose body fat”, “Be more active”, “To look good naked”.
6
What has been keeping you back from reaching your fitness goals?* This field is required.
Ex. “Don’t have the time to do the research”, “Nervous”, “Horrible past advice”.
7
Describe your past experience with fitness. What have you tried in the past to reach your goals?* This field is required.
Ex. “Used to go to the gym weekly”, “Never had any fitness experience”, “I do yoga every other day”, “Past personal trainers”.
8
Do you have any medical conditions, injuries, or physical limitations I should be aware of?* This field is required.
Huge
Large
Normal
Small
Ok
Ok
9
Do you have a preference between a gym, home gym equipment, or are you looking for bodyweight-only workouts?* This field is required.
Gym
Home Gym Equipment
Bodyweight Workouts
Either
10
What motivates you the most to stay on track?* This field is required.
Ex. “Seeing progress”, “Accountability”, “Feeling better overall”.
11
How many days per week can you realistically commit to working out?
Please Select
Please Select
1 Day
2 Days
3 Days
4 Days
5 Days
Should be Empty: