The Goal Standard Online Training Intake Form
Please fill out all of the information below to the best of your ability.
General Information
Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Height & Weight
*
Gender (optional)
*
Please Select
Female
Male
Prefer not to say
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Goals and Motivation
What are your PRIMARY fitness goals? (select all that apply)
*
Fat Loss
Strength Training
Toning
Performance Training
Gain Weight
Other
Why are these goals important to you right now?
*
What are your biggest barriers or struggles when it comes to fitness or nutrition?
*
How motivated are you to make a change?
*
Not at All
1
2
3
4
Very
5
1 is Not at All, 5 is Very
Timeline for achieving your goal.
*
Rows
8 weeks
3 months
6 months
9 months
1 year
Now
Have you worked with a trainer or coach before? If so, what did you like or dislike about your experience?
*
Training History
How long have you been consistently exercising? (2 weeks, 6 months, 1 year, etc..)
*
What type of training are you familiar with? (select all that apply)
*
Strength Training
HIIT
Yoga
Pilates
Bootcamp/ Class
Cardio
Sports Performance
How many days per week can you realistically commit to training?
*
Please Select
1-2 days
3-4 days
5+ days
Do you prefer home or gym workouts?
*
Home
Gym
Other
What equipment do you have access to? (List options)
*
Nutrition & Lifestyle
How would you describe your current eating habits? Do you follow any specific dietary style? (e.g. vegetarian, pescatarian, keto, etc...)
*
How many meals do you typically eat per day?
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1 meal
2 meals
3 meals
4+ meals
Any food allergies, intolerances or dislikes?
*
How much water do you drink daily?
*
Are you open to a 5-Day food journal via app?
*
Yes
No
Maybe
What is the activity level at your job?
*
None (seated only)
Moderate (light activity such as walking)
High (heavy labor, very active)
Health & Medical
Are you a current cigarette or vape smoker?
*
No
Yes option 2
Do you have any current or past injuries that would affect your training?
*
Do you have any medical conditions or medications that could affect training?
*
Schedule & Lifestyle Habits
What does a typical day look like for you? (work, commute, hours, etc...)
*
How much sleep do you get?
*
8+ hours
5-7 hours
Less than 5 hours
How would you rate your stress level?
*
Low
1
2
3
4
5
6
7
8
9
High
10
1 is Low, 10 is High
What time of day do you prefer to workout? (morning, midday, evening)
*
Wrap Up
What are 3 habits you would like to improve through this program?
*
Any additional information you would like me to know as your coach?
*
All the information on this form is correct and to the best of my knowledge. I have sought and followed any necessary medical advice. I understand that all of the information given will be kept confidential by The Goal Standard Fitness.
*
I Agree
I Disagree
Thank You for completing this intake form! We will contact you within the next 24-48 hours to discuss next steps and setup a phone consultation. If you have any additional questions please reach out via email.
thegoalstandardtraining@gmail.com
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