Individualized Training Programming Intake Form
Hello! Please tell us a little about yourself by completing a few questions. This will help us individualize a program specifically for YOU!
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What is your full name?
*
What is the best e-mail address to contact you and send mobile app account activation?
*
What are your goals?
*
What area of fitness are you interested in improving the most?
*
Building muscle mass
Improving strength
Losing body fat
Improving athletic/sports performance
Improving general health
Other
How much exercise experience do you have?
*
0-3 months
3 months - 1 year
1 year - 5 years
5 years +
Think of how much time that you have been exercising on a regular, consistent basis
Do you have any current or previous injuries that impact your ability to exercise?
*
Do you currently have access to a gym?
*
Yes
No
[Damn Covid-19}
⟶ If you answered No, what exercise equipment do you have access to?
How many days per week are you able to exercise?
*
Select Number of Days
2
3
4
5
6
7
What are you looking for in a coach? (If you have worked with a coach/trainer in the past, how was your experience?)
*
How motivated are you towards reaching your goals?
Selected Value:
0
0 = 0% motivated - 5 = 100% motivated
Is there anything else that you would like to share with us?
Name
Submit
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