Online Training Intake

STRENGTH FORMED LLC

Remote Coaching Intake
Full name

First NameLast Name
Birth Date

DayMonthYear
E-mail
example@example.com
Phone Number
Format: (000) 000-0000.
Clients informations - Health questionnaire (Par-Q)

The questions below are a legal requirement before we can start training together
Common sense is your best guide when you answer this questionnaire. Please read the questions carefully and answer each one honestly: check YES or NO.

Par-Q

Rows	Yes	No
Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?
Do you feel fain in your chest when you do physical activity?
In the past month, have you had chest pain when you were not doing physical activity?
Do you lose balance because of dizziness or do you ever lose consciousness?
Do you have bone or joint problem (for example, back, knee, or hip) that could be worsen by a change in your physical activity?
Is your doctor currently prescribing drugs (for example water pills) for your blood pressure or heart condition?
Do you know of any other reason why you should not do physical activity?

I have read, understood and completed this questionnaire. Any questions I had were answered to my full satisfaction
Initials
Do you have any previous injuries that need to be noted?
Do you have any other health conditions that would be a contraindication to strength training?
What are your top three goals for strength training?
Client informations - Liability waiver (T&Cs)

Our T&Cs keep us both protected from anything that comes up in the future. Please read and sign
1. Participation in any exercise program is voluntary. Any questions regarding programming will be answered to best of ability.

2. You are free to deny consent or withdraw consent at any time after consenting.
3. It is your full responsibility to inform your trainer of any difficulties you perceive or experience as well as any changes to your physical and medical condition.
4. Any questions you have about programming or intent of programming are welcomed.
5. You consent to being aware of your own health and physical condition and having knowledge that your participation in strength training may result in injury and you are voluntarily participating in this training program. Having such knowledge, you thereby release coach from liability for accidental injury, illness or death which you may incur as a result of participating in the said program. You hereby assume all risks connected therewith and consent to participate in said program.

6. Cleint understands that once payment is made, it is their responsibility to follow structured program.
7. Once payment is made, there will be NO REFUNDS unless there is an extenuating circumstance, or unless previously agreed between coach and client.
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STRENGTH FORMED LLC

Clients informations - Health questionnaire (Par-Q)

Client informations - Liability waiver (T&Cs)