Please fill out these questions as honestly as possible as they will assist me in setting up your initial plans!

CLIENT INTAKE FORM

Full Name

What are your BIG goals while working together?

When would you like to achieve these by?

What is your current weight training program? (days per week, sets, reps etc)?

What is your current cardio program (days per week, duration, intensity)?

What is your current diet (number of calories, grams of protein/carbs/fat)? If you are not sure, that is ok, please list what you've eaten for the past 3 days.

Are you gaining/losing/maintaining your bodyweight on your current protocol?

What is your current bodyweight (please indicate lbs/kg)?

Do you have any injuries or illnesses that I need to be aware of? Are you taking any medication?

How many days per week are you initially able to allocate towards workouts?

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