Clone of Client intake form

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Name
First Name
Last Name
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Email
example@example.com
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GENDER?
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AGE?
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HEIGHT?
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HOW LONG ARE YOUR WORKOUTS?
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ARE YOUR GOALS PERTAINING TO?FAT LOSS, REVERSE DIETING, OR BUILDING MUSCLE?
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WEIGHT?
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WHAT MOVEMENT PATTERN BOTHERS YOU?WHAT MOVEMENTS FEEL LIMITED OR DIFFICULT?
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ARE YOU WILLING TO SUBMIT VIDEOS FOR ASSESSMENT AND FORM FEEDBACK?
YESNO
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ARE YOU LOOKING FOR REHAB, GENERAL STRENGTH, FAT LOSS, POSTURE, MOBILITY OR PERFORMANCE?
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ARE YOU READY TO START A STRUCTURED PROGRAM FOR AT LEAST 3 MONTHS?
YESNO
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DO YOU TRAIN IN A GYM OR AT HOME?WHAT GYM EQUIPTMENT DO YOU HAVE ACESS TO?
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HOW MANY DAYS A WEEK ARE YOU CURRENTLY WORKING OUT?
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WHAT LEVEL OF EXPERIENCE DO YOU HAVE WITH WEIGHTLIFTING?
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DO YOU HAVE ANY MEDICAL ISSUES OR INJURIES?
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PLEASE EXPLAIN IN DETAIL
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Small
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Ok
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Do you have any medical issues and/or injuries that prevent you from activity/exercise?
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PLEASE EXPLAIN IN DETAIL:
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Small
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Ok
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Are you familiar with tracking macros?
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What are your current macros on any given day?
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Goals: Be specific:
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Large
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Ok
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GOAL WEIGHT?
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*B STRONG TRAINING METHODS- LIABILITY DISCLAIMER & TERMS OF SERVICE* This field is required.B STRONG Training Methods strongly recommends that you consult with your physician before beginning any exercise program, nutrition protocol, or lifestyle change described in any B STRONG Training Methods content, including but not limited to programs, workouts, videos, emails, guides, online courses, digital products, and mobile content (“B STRONG Content”). You must be in good physical condition to participate safely in the exercises described in B STRONG Content. By accessing, purchasing, or participating in any B STRONG program, you affirm that you are in good physical condition and do not suffer from any condition, medical or otherwise, that would limit or prevent your ability to participate in vigorous physical activity. These activities may include, but are not limited to: resistance training, bodyweight exercises, cardiovascular training, plyometrics, stretching, mobility work, and other forms of physical exertion. You understand and acknowledge that participating in any exercise program carries inherent risks. By choosing to engage in B STRONG Content, you voluntarily assume full responsibility for any and all injuries or damages—known or unknown—that you may sustain as a result of your participation. These risks may include, but are not limited to: heart complications, muscle strains or tears, sprains, fractures, joint injuries, back injuries, foot injuries, heat-related illness, or other physical discomfort, complications, or conditions, including death. By participating, you hereby release B STRONG Training Methods, its owners, coaches, contractors, and representatives from any and all liability, claims, demands, or causes of action related to your participation now or in the future. B STRONG Training Methods is **not** a licensed medical provider and does **not** claim expertise in diagnosing, treating, or advising on medical conditions. All information provided through B STRONG Content is for educational and informational purposes only and is **not a substitute** for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider before making decisions regarding your health. Never disregard or delay seeking medical advice because of something you have read, watched, or learned through B STRONG Content. Never rely solely on B STRONG Content in place of professional medical guidance. By proceeding, you acknowledge that you have read, understood, and agree to these Terms of Service.
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ORDER SUMMARY
Total costUSD
Movement Assessment
Movement Assessment

$199

A one-on-one session focused on identifying movement limitations, strength imbalances, and exercise patterns that may be contributing to discomfort or plateaus in training.

Includes a movement screen and recommendations for improving strength and mobility.
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Quantity
Online Strength Coaching
Online Strength Coaching

$175 per month ($525 - 3 MONTHS)

For women who want a personalized strength program and coaching support but train independently at their own gym or at home.

Includes

Personalized strength program delivered through Trainerize
Exercise demonstrations and instructions
Progress tracking
Program adjustments based on progress

Commitment
Online coaching requires a 3-month minimum commitment to allow time for proper program progression and measurable strength improvements.

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Online Strength + Nutrition Coaching
Online Strength + Nutrition Coaching

$250 per month ($750 3 MONTH)

For anyone who want both personalized training and macro guidance while training independently.

This option combines expert programming with nutrition coaching to support strength and body composition goals.

Includes

Personalized strength program in Trainerize
Exercise demonstrations and instructions
Customized macro targets
Weekly macro coaching and adjustments
Progress tracking and program updates

Commitment
This coaching option includes a 3 month minimum commitment to allow time for both training progression and nutrition adjustments.
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Total cost
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