Fitness Intake Form

1
Name
First Name
Last Name
2
Email
example@example.com
3
On a scale of 1-10, how committed are you to making changes to your fitness and lifestyle in the next 3 months?
Fat Loss / Weight Loss
Muscle Gain / Toning
Strength & Performance
Improve Overall Health / Lifestyle Change
4
What is your main fitness goal right now? (e.g., weight loss, strength, muscle building or body confidence).
Please Select
Please Select
1 – Not committed at all
2–4 – Interested but unsure
5–7 – Fairly committed, ready to start
8–10 – Extremely committed, nothing will stop me
5
Have you worked with a fitness coach or trainer before?
Yes - currently wiith a coach/ trainer
Yes - worked with one in the past
No, this would be my first time
6
Phone
Should be Empty: