Client Intake Form - Personal Training & Lifestyle Coaching What is your first name ? What is your last name ? What is your age ? Are you male or female ? What is your e-mail address ? What is your phone number ? What city do you live in ? What is your current profession ? Instagram Handle (If you don't have Instagram, type NA) What is your Skype username ? How tall are you in centimeters ? What is your current weight in kilograms ? Have you been a member of a gym before ? Why did you quit (or not achieve success) previously ? Have you had a trainer before ? What is your training experience in years ? How many days per week can you commit to the gym ? Squat 1RM (One Rep Max) Bench 1RM (One Rep Max) Deadlift 1RM (One Rep Max) Do you have injuries or medical conditions that must be taken into account ? What are your primary health & fitness goals ? What are your expectations of me ? What results are you looking for ? What are some of the obstacles that hold you back from achieving your goals on your own ? What would it mean to you if you overcame these obstacles and finally reached your health & fitness goals ? How did you hear about my coaching services ? Why did you choose to be coached by me specifically ? If we are a good fit to work together, are you willing to make the investment in yourself to hire a coach and overcome these obstacles ? 1 + 5 = Submit
