Coaching Intake Form

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Please fill out this form completely and honestly. I am not looking for answers to impress me--I just want to know where you're currently at so I can help you the best!

Once I have your responses, I will contact you within 24-48 hours to schedule a time with you to go over your answers.

What is your name? *

What is your age? *

What is your email address? *

What is your social media (or anywhere else to contact you)? *

How did you find me? (social media, referral from current/previous client, met in person, etc)

What is your primary goal? *

Do you have any secondary goals?

Why are these goals important to you? *

What do you feel are your biggest obstacles to success? *

What sport/division do you compete in OR want to compete in? *

Please describe your previous experience working with a coach (how long you worked with them, what you liked, didn't like, etc) *

Please list/describe previous strength programs you have used (how long you used it, what you liked, didn't like, etc) *

Please list any current/previous injuries and describe how they effect your training *

Please list the gym equipment you have available to you on a consistent basis *

Please list your current height/weight *

Please list your current/recent squat/bench/deadlift maxes (or any lifts/events that are important to you) *

Please describe your current sleeping habits *

Please describe your current cardio habits *

Please describe your current nutrition habits *

Please describe your typical weekly/daily work and lifestyle (e.g. office job, physical labor, work from home, lots of kids, travel, etc) *

Please list current supplementation use (over the counter/health supplements and performance supplements) *

If you use performance supplements, do you/are you able to get bloodwork done?

I expect my clients to provide videos of their lifts, update their training logs, communicate with me on a consistent basis, and provide honest feedback on how training is going. Are you able to do this? *

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