Client Intake Form

Client Intake Form
Health & Lifestyle
1. Do you have any current injuries, medical conditions, or limitations I should know about?
Please list anything that may impact your ability to train or follow a nutrition plan.
2. Are you currently taking and medication or supplements?
If yes, please list them.
3. On a scale of 1–10, how would you rate your current knowledge of exercise and nutrition?
1 = beginner, 10 = extremely knowledgeable
4. How many days per week do you currently work out?
5. What kind of exercise do you usually engage in, if any?
e.g., weightlifting, cardio, sports, yoga, group classes, etc.
6. What time of day do you prefer to work out?
Goals & Motivation
7. What is your primary goal for seeking a fitness coach?

Other
8. What is it you hope to learn from this experience?
9. Do you have a specific timeline or event that our training for?
e.g., wedding, vacation, competition, etc.
10. On a scale of 1-10, how committed are you to reaching your goals?
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11. What has held you back from reaching your goals?
Be honest — this helps us create a plan that works for YOU.
12. What do you seek in a trainer or coach?
e.g., motivation, accountability, education, empathy, tough love, etc.
13. Do you prefer more structure or more flexibility in your workout and nutrition plan?
14 Are you more motivated by:
15. Is there anything else that needs to be addressed before we get started?
Now, Let's Do This!

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Health & Lifestyle