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Height

Weight

Occupation + Daily Activity Level

(ie: Sedentary, Active, Highly Active)

What is your primary goal for the next 5 months? (e.g., build muscle, improve endurance, increase flexibility, develop better nutrition habits).

Do you have a specific timeframe by which you would like to achieve these?

Why is this goal important to you? How does it align with your lifestyle and values?

Where are you in relation to these goals?

Why have you not yet reached your goals? Identify possible challenges.

List all physical activities that you currently enjoy or would like to include in your personalized program:

What equipment do you have access to?

How many days a week can you realistically commit to training? And for how long (ie: how much time do you have)?

Do you have any previous experience with weightlifting, yoga, or calisthenics? If so, please describe.

Are there any exercises or movements you’d like to focus on or avoid?

Have you ever worked with a coach or trainer before? If yes, please describe.

What is the best way for me to coach you effectively? What tips would you give me about how you operate?

Do you have any upcoming life events that you are planning for? Remember, life will always win. We need to reverse engineer our program around that.

Are you currently seeing a medical doctor or counselor? If yes, please describe.

Are you currently following any structured fitness or nutrition plan?

Do you track your protein intake, hydration, exercise, steps, or sleep? If so, how?

Do you have (or have you had) any injuries, surgeries, mobility restrictions, or medical conditions I should be aware of?

How are you willing to track progress? (e.g., tracking weights lifted, taking progress photos, monitoring body composition, logging your food intake, or any other method that works for you)

How many meals do you typically eat per day?

Do you have any dietary restrictions or preferences?

How do you prefer to receive feedback and motivation? (e.g., direct and to the point, encouraging and supportive, a mix of both)

What would an ideal program and coaching experience look like for you? What do you expect from me as your coach, and can you clarify your understanding of what you will be receiving over the next few months?

What do you think is the the biggest barrier we need to address to ensure program success?

Do you have any concerns or questions about the program?

What made you choose to work with me as your coach? Is there something specific about my approach, expertise, or coaching style that resonates with you?

Is there anything else you’d like to share with me before we begin?

Women’s Health Intake Form