Client Intake Form
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
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Email
example@example.com
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What type of training are you looking for?
In Person
Online Coaching
Nutrition Planning
Other/Unsure
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What is your current height/weight/age?
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What are your top 3 goals?
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What type of training/activities are you currently doing?
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How many days per week do you currently exercise?
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Do you have any food allergies or dietary restrictions?
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Describe a typical day of eating for you.
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How many hours of sleep do you average per night?
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How would you rate your daily stress 1-10?
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Do you have any current or past injuries that could affect your training?
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What challenges do you think might get in the way of your fitness goals?
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Are you ready to fully commit to becoming the strongest, most capable, confident, version of yourself?
Yes
No
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