PRIME AGAIN form

  • PRIME AGAIN

    CLIENT INTAKE FORM
  • You are*

  • 1/11 YOUR GOAL

  • What is your goal ?*
  • 0/500

  • 2/11 BODY AREAS

  • Which areas of your body bother you the most ?*

  • 3/11 TRAINING BACKGROUND

  • Are you currently training?*
  • How many times per week?*
  • What type of training?*
  • Have you trained in the past?*

  • 4/11 NUTRITION OVERVIEW

  • How would you describe your nutrition?*
  • Are you currently following any specific dietary approach?*
  • Do you eat late at night?*
  • Do you crave sugar or snacks?*

  • 5/11 ENERGY AND RECOVERY

  • Do you feel tired during the day?*
  • Do you wake up refreshed?*
  • Do you experience energy crashes?*
  • How many hours do you sleep?*
  • Stress level*

  • 6/11 HORMONAL / INTERNAL FACTORS

  • Are you on hormone therapy (TRT, etc)?*
  • Have you done bloodwork recently?*
  • Any known hormonal or metabolic issues?*

  • 7/11 SUPPLEMENTS AND MEDICATIONS

  • 10 (12) INJURIES AND LIMITATIONS

  • Do you have any injuries or limitations?*
  • Any movements that cause discomfort?*

  • 11 (12) LIFESTYLE

  • Daily activity level:*
  • *

  • 12 (12) COMMITMENT AND STRUCTURE

  • How often can you realistically train in a gym?*
  • Preferred training time?*
  • Have you worked with a coach before?*
  • What gym would you prefer to use?
  • On a scale from 1 to 10 how serious are you about achieving your goal right now?*
  • Are you ready to invest in yourself to achieve real results (supplements, blood test, coaching)?*
  • Should be Empty: