• NEXO 360 — Part 1: Client Profile & Health/Performance Intake

    Share your goals, history, and current lifestyle so your NEXO trainer can tailor your program.

  • Profile

  • Who is completing this form?*
  • Date of birth*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Format: (000) 000-0000.

  • Goals

  • What brings you to NEXO?*

  • Success & Expectations

  • Weight & Body-Composition History

  • Previous approaches tried

  • Health History

  • Overall health status*
  • Have you ever been diagnosed with or treated for any of the following?*
  • If any condition was selected, provide brief details or relevant notes
  • Do you currently have a primary care provider?*
  • Has a healthcare professional ever advised you to limit or avoid exercise?*
  • Has a healthcare professional recommended exercise for any particular condition or concern?*
  • Health and safety note

  • Medications & Therapies

  • Are you currently taking any prescription medications?*
  • Prescription medications
  • Have you ever used a GLP-1 / GIP weight-management medication?*
  • Which medication(s) have you used?
  • Current / recent tolerance
  • Which side effects or challenges have you experienced?
  • Current GLP-1 / GIP medication details

  • Surgeries, Injuries & Pain History

  • Have you had any previous surgeries?*
  • Approximate surgery date
     - -
    2 digit month, 2 digit day, 4 digit year
  • Have you been fully cleared by a healthcare professional for exercise after this surgery?
  • Which areas have you had an injury or pain in?
  • For the area(s) selected above, is this a past issue or a current/recurrent issue?
  • Does exercise usually aggravate this area?
  • Are you currently experiencing pain or recurrent discomfort that could affect exercise?*

  • Exercise History

  • How many days per week do you currently exercise?*
  • Which best describes your exercise experience level?*
  • How long have you been consistently training?*
  • Which of the following have you done before?

  • Daily Activity & Steps

  • Work / activity type*
  • Do you track your daily steps?*
  • Typical sitting hours per day*
  • Comfortable walking duration*

  • Cardiovascular Activity

  • Which cardio activities do you feel comfortable doing?*
  • Do you ever feel unusual shortness of breath during normal daily activity?*

  • Nutrition

  •
  • Eating patterns

  • Hydration & Beverages

  • About how much water do you drink on an average day?*
  • Which beverages do you regularly consume?
  • How often do you drink alcohol?

  • Sleep & Recovery

  • Typical sleep duration*
  • Do you track sleep?*

  • Stress & Lifestyle

  •
  • Primary stress sources*

  • Training Logistics

  • Where will you train most often?*
  • What equipment do you have access to?*
  • What is your preferred workout duration?*
  • Preferred training days, times, and availability

  • Everfit Onboarding Readiness

  • Everfit will be used for ongoing NEXO program workouts, habits, progress tracking, and coaching communication. During onboarding, your final tracking setup will be agreed with your coach, and you do not need to track everything.
  • Preferred mobile device*
  • What are you comfortable tracking in Everfit?

  • Barriers & Accountability

  • What commonly gets in the way of your progress?*
  • What helps keep you accountable?*

  • Personal Comfort & Training Environment

  • What would make your training environment more comfortable or inclusive?

  • Baseline Self-Rating

  •

  • Client Voice

  • Consent & Acknowledgments

  • Acknowledgments*
  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Should be Empty: