Initial Intake Form
Name
First Name
Last Name
Email
example@example.com
In your own words, what are the primary 1-2 improvements you are striving to achieve?
What are the main obstacles you've faced that have kept you from making the progress you want to make?
How often do you currently exercise?
Never
1x per week
2-3x per week
4x or more per week
How would you describe your experience with strength training?
Brand new
New-ish (Recently started strength training)
Recreational (Have done strength training but without a structured program)
Experienced (Have been strength training consistently for several years while following some sort of structure much of the time)
Do you have experience tracking your nutrition?
No, not at all
Yes, I've done it in the past
Yes, I'm currently tracking my nutrition manually or with the support of an app
Is there anything else you think is noteworthy regarding your health and fitness goals? If so, explain.
Submit Form
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