2:1 Training Intake Form

2:1 Training Intake Form

We will help you uncover your blindspots and problem areas that are holding you back, create a custom fitness and nutrition plan aligned to your goals, and help you simply and create a sustainable lifestyle so you can stay committed and get the results you’re looking for. Take time filling this form out so we can understand your goals.
Name*

First NameLast Name
Email*
example@example.com
Today's Date*

MonthDayYear
Today's Date
Phone Number*
Please enter a valid phone number.
Age*
Height*
Current Weight*
Any current/past injuries, medical conditions, or chronic pain we should be aware of?*
Describe you overall health & fitness goals and desire for improvement that made you decide to take this next step.
Describe your current activity level

Sedentary (sit a lot, little movement)Light activity (exercise 1-3x a week)Moderately active (exercise 4-5x a week)Very active (exercise 6-7x a week)Extremely active (physical job, exercise 5-7x a week)
Describe your comfort level with weight training
What concerns do you have about this next step you are taking to exercise? What makes you worried or nervous that we should know about?
What has worked well for you in the past when trying to reach your goals?
What excites you about this journey? What do you want this journey to look or feel like in 3-6 months? What does success look like for you?
On a scale of 1-10, how committed are you to making a real change in your health & fitness?
How many meals or snacks do you typically eat in a day?

12345+
Do you currently follow a specific nutrition plan or style of eating? If so, which one?
(Examples: macros, intuitive eating, keto, high protein, low carb, intermittent fasting, etc.)
What feels most challenging about nutrition for you right now?
Examples: meal prep, cravings, portion control, confusion about what to eat, emotional eating, etc.
Do you prep or plan meals ahead of time?
Do you track your food in any way?
Are there any dietary restrictions or preferences we should know about?
What is your top nutrition goal right now?
After submitting this form, we will reach out to schedule a zoom call and talk through how 2:1 Personal Training with Strong Mama can support you. We can't wait to connect!
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