Client Intake Form
Basic Information
Client Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Date of Birth
Address
Province/ State
What is your current height? (ft)
What is your current weight? (lbs)
Gender
Female
Male
Nonbinary
Other
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Goals & Expectations
What are your primary fitness goals? (Check all that apply)
Weight loss
Build Muscle
Strength Training
Endurance/ Cardio Fitness
Flexibility/ mobility
Sports Performance
General Health & Wellness
Nutrition
Other
What are your health goals? Do you have a specific time frame for reaching your goals?
How many days a week are you willing to commit to training in the gym? (Life is busy! Please be realistic with your daily schedule and what best suits your needs)
What are you looking for within a trainer? (The more detailed the better 😁)
What are you looking for?
Online Coaching
In-person coaching
Hybrid
Appointment
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