Athlete Intake Form
Todays Date
/
Month
/
Day
Year
Date
Last Name, First Name
Date of Birth
/
Month
/
Day
Year
Date
Sex
Email
example@example.com
Athlete Information
Sport(s)
Previous Injuries and/or Surgeries
Current Training Program
Have you lifted before?
Yes
No
For how long
Why do you want to join the clinic
Goals
Athlete Consent
Date
/
Month
/
Day
Year
Date
Guardian Consent if minor
Date
/
Month
/
Day
Year
Date
Submit
Should be Empty: