Grow With O: Client Intake Form

GROW WITH O: Client Intake Form

Welcome! You're here because you have expressed serious interest in taking your mind, body and spirit to new levels under the guidance of trainer and transformer, Osamoje.
Which of the following are you interested in? (select all that apply)
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Birth Date

MonthDayYear
Sex assigned at birth
Weight
lb
Height
ft
Instagram Handle
link to instagram account
LinkedIn Account
Do you have any diagnosed health problems?
asthma, diabetes, etc.
Do you have any current injuries? If yes, please list below.
How does your current diet look like?
Do you smoke?
How frequently do you consume alcohol?
What is your daily stress level?

1

2

3

4

5

1 is Low, 5 is High
How would you describe your current level of fitness?
How may days a week can you commit to exercising?
Which of the following statements fit in with your goals? (select all that apply)
What would success look like 3 months into your fitness journey?
What is your "why"?
Why have you decided to embark on this journey?
What is your expected monthly investment for coaching?
If selected to be a part of the Grow With O training experience, how soon can you begin?
Should be Empty:

GROW WITH O: Client Intake Form