Thrive With Sophie Intake Form
Welcome to Thrive with Sophie – Let’s build the strongest, healthiest version of you. This form helps me get to know your goals, your lifestyle, and how I can best support your journey.
Client Name
First Name
Last Name
Birth Date
-
Month
-
Day
Year
Date
Phone Number
Email
example@example.com
Emergency Contact Name
First Name
Last Name
Emergency Contact Phone Number
Please state if you have current/previous health diseases/issues.
Please state whether you take any medication.
Health & Lifestyle
Yes
No
Do you smoke?
Have you had any surgery since one year?
Do you drink alcohol?
Are you using any additional vitamin or supplements?
Are you tracking your daily food intake?
Have you done sports professionally before?
Do you feel pain while doing sports/exercise?
How many times a day do you eat?
0
0
1
2
3
4
5x
5
0 is 0, 5 is 5x
What is your rate for your nutrition?
Poor
0
1
2
3
4
Excellent
5
0 is Poor, 5 is Excellent
How often do you exercise per week?
How many days a week are you able to train?
Current activity level:
Lightly Active
Moderately Active
Very Active
Please select the best days you can exercise.
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Please select the best times you can exercise.
Early Mornings
Mornings
Early Afternoons
Afternoons
Evenings
What type of training do you prefer?
In person
Online
A mix of both
Other
Do you have access to a gym, home gym, equipment/ or facility?
Yes
No
What are your goals for training?
Muscle Development
Reducing stress
Losing body fat
Increasing motivation
Training for an event/specific sports
Other
How soon do you want to acheive your goals?
3 months
6 months
1 year
1 yr +
What do you expect from a personal trainer?
Anything else you would like to share to help me create the best program for you?
Are you financially ready to invest in YOU and take the next step on becoming THE BEST YOU?!
YES! I am willing to put in the work!
No, not financially ready but I want to talk about options
Other
Submit
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