6 Week Start Program Intake Form ✍️

Start Program Intake Form ✍️
Basic Info
Full Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: 000-000-000.
Have you done CrossFit before?*

YesNoTried it once or twice
How would you describe your current fitness level?*

Beginner (starting from zero)Getting back into itSomewhat activeVery active
What made you consider starting now?*
What would you like to achieve in the next 6–12 weeks?*

Build strengthLose fatImprove fitness/conditioningFeel more confidentGet back into a routineOther
If everything went well, what would success look like for you?*
What has stopped you from staying consistent in the past?*

Lack of timeDidn’t know what to doLost motivationFelt intimidated in gymsNo support/accountabilityOther
What frustrates you most about your current situation?*
How ready do you feel to start something now?*

Just exploringThinking about starting soonReady to start now
If this feels like the right fit, when would you want to begin?*

ImmediatelyWithin 2 weeksLater
What would you like help with most on the call?*

Understanding how the program worksSeeing if it’s right for meGetting startedPricing & options
If accepted, are you willing to commit to the full 6-week program?*

YesI’d like to learn more first
On a scale of 1–10, how important is it for you to make a change right now?

1

2

3

4

5

6

7

8

9

10

1 is Not important, 10 is Extremely important
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Start Program Intake Form ✍️