• Client Intake & Health Questionnaire

    Welcome to Choice Lyfestyle's Online Performance Training Program. This form will help us gather important information about your health history, background, training experience, and goals so we can create a safe, effective, and individualized training program for YOU. This program is designed for individuals who are committed, coachable, compliant with their training program, and serious about achieving their goals. The greatest results are achieved through consistency, communication, effort, and adherence to the prescribed program.Please answer all questions honestly and thoroughly. The information provided will be used for program design, monitoring, and coaching purposes. After this form has been completed, signed, and reviewed, the next step in the onboarding process will be a 15-20 minute virtual consultation to discuss your goals, training history, expectations, and program details. Your Coach will reach out to you to schedule your consultation. Thank you for trusting Choice Lyfestyle LLC with your fitness journey! We look forward to helping you accomplish your goals! The Choice Is Yours.

  • Personal Information

  • Date of Birth*
     - -
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • Health Screening (PAR-Q+)

  • Please answer YES or NO to the following:
  • Has your doctor ever said you have a heart condition and that you should only do physical activity recommended by a doctor?*
  • Do you feel pain in your chest during physical activity?*
  • In the past month, have you experienced chest pain when not exercising?*
  • Do you lose balance because of dizziness or have you lost consciousness?*
  • Do you have any bone, joint, muscle, or orthopedic issues that could be aggravated by exercise?*
  • Are you currently taking medications for blood pressure, heart conditions, or any chronic illness?*
  • Has a doctor ever recommended restrictions on your physical activity?*
  • Are you pregnant or have you given birth within the past 6 months?*
  • Do you have any medical condition that may affect your ability to exercise safely?*

  • Medical History

  • Lifestyle Assessment

  • Work Type
  • Average Sleep per Night
  • Water Intake per Day
  • Exercise Days per Week

  • Nutrition Habits

  • Nutrition Rating*

  • Fitness Background

  • Have you worked with a personal trainer before?*
  • Exercise experience level*
  • Types of training experienced

  • Goals & Expectations

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  • Program Preferences

  • Training days per week*
  • Primary training location*
  • Available equipment

  • Client Agreement

  • Coaching Agreement & Liability Waiver: By participating in Choice Lyfestyle LLC training and coaching services, I understand there are inherent risks, including injury or, in rare cases, serious harm.

    I confirm that I am physically able to participate and have disclosed any medical conditions, injuries, medications, or concerns that may affect safe participation.

    I understand this program is for educational and performance purposes only and is not medical care, diagnosis, physical therapy, or treatment. I will stop and notify Choice Lyfestyle LLC if pain, injury, or health changes affect my ability to train safely.

    I accept responsibility for training in a safe environment, using proper equipment, and following instructions. Results are not guaranteed and vary by individual.

    In exchange for participation, I voluntarily assume the risks and release Choice Lyfestyle LLC, its owners, coaches, contractors, and affiliates from claims arising from participation, except in cases of gross negligence or willful misconduct.

    I have read, understood, and voluntarily agree to this waiver.

  • Date*
     - -

  • Submission of this form does not guarantee enrollment. Everyone must complete a consultation and be approved for participation before receiving access to training services. Program access will be granted upon completion of the enrollment process and successful payment setup.

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