Personal Fitness and Movement Training Intake Form

I. Personal Information

First Name

Last Name


Date of Birth

Gender

Street Address

City

State/Province

Postal/Zip Code


Phone Number

Email Address


Emergency Contact Name

Emergency Contact Phone Number

II. Health History

Have you been diagnosed with any medical conditions?

Are you currently taking any medications?

Do you have any allergies?

Have you had any recent surgeries or injuries?

Do you experience any chronic pain or discomfort?

Do you have any cardiovascular conditions (e.g., high blood pressure, heart disease)?

Do you have any respiratory conditions (e.g., asthma)?

Do you have any musculoskeletal conditions (e.g., arthritis, osteoporosis)?

Are you currently pregnant or postpartum?


Do you have any dietary restrictions or preferences?

Are you currently under the care of a physician or other healthcare professional?

Have you been cleared for exercise by your physician?

III. Fitness and Lifestyle

What are your primary fitness goals?

What is your current activity level?

Describe your typical daily activity:

Do you currently participate in any regular exercise or sports?

How often do you exercise per week?

How long do you typically exercise per session?

What types of exercise do you enjoy?

What types of exercise do you dislike?

Do you experience any limitations or challenges with movement?

How would you rate your current stress level? (1-10) (Scale: 1-Low Stress, 10-High Stress)

How many hours of sleep do you typically get per night?

Describe your typical dietary habits:

Do you smoke or use tobacco products?

Do you consume alcohol?

IV. Training Preferences and Availability

What are your preferred days and times for training?

Do you prefer individual or group training?

What is your budget for training?

Do you have access to any fitness equipment at home or a gym?

What type of training environment do you prefer? (e.g., gym, outdoors, home)

Do you have any previous experience with personal training?

What are your expectations from a personal trainer?

How long do you plan to train?

V. Service Options (Please check all that apply)

Individual Training:

Group Training:

Specialized Training:

VI. Suitability and Client Understanding

Based on your health history and fitness goals, which of the services listed above do you feel are most suitable for you? Why?

Are you aware that some training programs require a certain level of physical fitness or medical clearance?

Do you understand that results vary from person to person and depend on adherence to the training program and lifestyle changes?

Are you willing to commit to a consistent training schedule and follow the trainer's guidance?

Are you aware that you are responsible for informing the trainer of any changes in your health or fitness status?

Do you have any questions or concerns about the training services offered?

VII. Agreement and Consent

I have read and understood the information provided in this intake form.

I certify that the information provided is accurate and complete to the best of my knowledge.

I understand that I am responsible for informing the trainer of any changes in my health or fitness status.

I consent to participate in the fitness and movement training program as described.

I release the trainer and their affiliates from any liability for injuries or damages that may occur during training, except in cases of gross negligence.

Client Signature:


Client Intake Form Insights

Please remove this client intake form insights section before publishing.


Important Considerations:

  • Medical Clearance: Emphasize the importance of obtaining medical clearance from a physician, especially for clients with pre-existing conditions.
  • Liability Waiver: Ensure you have a comprehensive liability waiver in place.
  • Privacy Policy: Comply with all relevant privacy laws and regulations regarding the collection and use of personal information.
  • Regular Updates: Encourage clients to update their health and fitness information regularly.
  • Professionalism: Maintain a professional and supportive environment for all clients.
  • Adaptability: Be prepared to adapt training programs to meet the individual needs and abilities of your clients.

This detailed intake form will help you gather the necessary information to create a personalized and effective training program for your clients. Remember to review the form carefully with each client and address any questions or concerns they may have.


Let's break down this training intake form section by section, providing detailed insights into its purpose and importance:


Section 1: Personal Information

  • Purpose: This section establishes basic client identification and contact details. It's crucial for record-keeping, communication, and emergency situations.
  • Insights:
    Accurate contact information is vital for scheduling, reminders, and follow-ups.
    Emergency contact details are essential for safety and should be verified.
    Date of birth helps determine age-related considerations for training.

Section 2: Health History

  • Purpose: This is the most critical section for assessing client safety and identifying potential risks. It helps determine if the client is suitable for specific types of exercise and if medical clearance is required.
  • Insights:
    Detailed medical history allows the trainer to understand pre-existing conditions and potential limitations.
    Medications can affect exercise performance and should be noted.
    Allergies are essential to know, especially if using equipment or products.
    Past injuries or surgeries can influence exercise selection and intensity.
    Cardiovascular, respiratory, and musculoskeletal conditions require careful consideration.
    Pregnancy and postpartum require specialized training and precautions.
    Dietary restrictions are important for nutritional coaching.
    Physician clearance ensures safety and legal protection.
    This section protects both the client and the trainer.

Section 3: Fitness and Lifestyle

  • Purpose: This section gathers information about the client's current fitness level, activity habits, and lifestyle factors that can impact training outcomes.
  • Insights:
    Fitness goals help tailor the training program to the client's specific needs.
    Activity level provides a baseline for assessing current fitness and determining appropriate exercise intensity.
    Exercise preferences and dislikes are essential for creating an enjoyable and sustainable program.
    Movement limitations help identify areas that require attention and modification.
    Stress levels, sleep patterns, and dietary habits significantly impact overall health and fitness.
    Smoking and alcohol consumption are very important lifestyle factors that need to be recorded.

Section 4: Training Preferences and Availability

  • Purpose: This section gathers information about the client's preferences for training style, schedule, and budget.
  • Insights:
    Training preferences ensure client satisfaction and adherence.
    Availability helps create a realistic training schedule.
    Budget considerations allow the trainer to offer appropriate service options.
    Access to equipment and training environment influences program design.
    Previous training experience helps the trainer understand the clients understanding of fitness.
    Client expectations are very important, so the trainer can manage them.

Section 5: Service Options (Please check all that apply)

  • Purpose: This section clearly outlines the range of services offered, allowing the client to select the options that best meet their needs.
  • Insights:
    Clearly defined service options help the client understand what is available.
    Specialized training options cater to diverse client needs and goals.
    This section helps to open up a conversation about what the client is looking for.

Section 6: Suitability and Client Understanding

  • Purpose: This section assesses the client's understanding of the training process, potential risks, and their commitment to the program.
  • Insights:
    Client self-assessment of suitable services encourages active participation.
    Addressing awareness of fitness requirements and medical clearance ensures safety.
    Managing expectations regarding results promotes realistic goals.
    Assessing commitment ensures client adherence and motivation.
    Addressing questions and concerns fosters open communication.
    This section is designed to make sure the client is fully informed.

Section 7: Agreement and Consent

  • Purpose: This section provides legal protection for the trainer and confirms the client's understanding and agreement to participate in the training program.
  • Insights:
    Client signature confirms understanding and consent.
    Release of liability protects the trainer from legal claims, except in cases of gross negligence.
    Accurate documentation is essential for legal protection.
    This section is very important for legal reasons.

Overall Importance:

  • Client Safety: The form prioritizes client safety by gathering detailed health information.
  • Personalization: It enables the trainer to create personalized training programs tailored to individual needs and goals.
  • Effective Communication: It fosters open communication and helps establish a strong client-trainer relationship.
  • Professionalism: It demonstrates professionalism and commitment to client well-being.
  • Legal Protection: It provides legal protection for the trainer and ensures informed consent from the client.

By thoroughly reviewing and utilizing this intake form, trainers can ensure a safe, effective, and positive training experience for their clients.


Mandatory Questions Recommendation

Please remove this mandatory questions recommendation section before publishing.


While the specific legal requirements can vary slightly depending on your location and the exact nature of your services, here's a breakdown of the questions on this intake form that are generally considered mandatory or highly recommended from a safety, legal, and practical perspective:

Absolutely Mandatory (Primarily for Safety and Legal Reasons):

  • Full Name: Essential for identification and record-keeping.
  • Date of Birth: Important for age-related considerations and legal agreements.
  • Emergency Contact Name & Phone Number: Crucial for immediate contact in case of an emergency.
  • Have you been diagnosed with any medical conditions? If yes, please specify: This is paramount for understanding potential risks and contraindications to exercise.
  • Are you currently taking any medications? If yes, please list: Medications can significantly impact exercise and need to be considered.
  • Have you had any recent surgeries or injuries? If yes, please specify: These can directly affect exercise limitations and program design.
  • Do you have any cardiovascular conditions? Important for assessing risk related to cardiovascular exercise.
  • Do you have any respiratory conditions? Essential for understanding potential limitations during exercise.
  • Do you have any musculoskeletal conditions? Crucial for safe and effective movement training.
  • Are you currently pregnant or postpartum? Requires specialized training considerations.
  • Have you been cleared for exercise by your physician? (Highly recommended, especially if the client answers "yes" to any significant health history questions).
  • Client Signature & Date: Legally binds the client to the information provided and their consent.

Highly Recommended (For Effective Training and Client Understanding):

  • Phone Number & Email Address: Essential for communication and scheduling.
  • Primary Fitness Goals: Necessary to tailor the training program effectively.
  • Current Activity Level & Description of Typical Daily Activity: Provides a baseline for assessing fitness.
  • Do you experience any limitations or challenges with movement? Helps identify areas needing attention.
  • What are your preferred days and times for training? Practical for scheduling.
  • Are you aware that some training programs require a certain level of physical fitness or medical clearance? Ensures the client understands potential requirements.
  • Do you understand that results vary from person to person...? Manages expectations.
  • Are you willing to commit to a consistent training schedule...? Assesses client commitment.
  • Are you aware that you are responsible for informing the trainer of any changes in your health...? Reinforces client responsibility.
  • I have read and understood the information provided in this intake form. Confirms client understanding.
  • I certify that the information provided is accurate and complete to the best of my knowledge. Holds the client accountable for the information given.
  • I consent to participate in the fitness and movement training program as described. Explicitly states their agreement to participate.
  • I release the trainer and their affiliates from any liability... (Crucial for legal protection, but wording should be reviewed by legal counsel in your specific location).

Less Critical (But Still Useful for Personalization):

  • Address
  • Emergency Contact Relationship
  • Allergies (important, but might be less critical than major medical conditions)
  • Chronic pain details
  • Dietary restrictions/preferences
  • Care under other healthcare professionals
  • Exercise history (types, frequency, duration, enjoyment, dislikes)
  • Stress level, sleep habits, smoking/alcohol consumption
  • Budget for training
  • Access to equipment/training environment
  • Previous experience with personal training
  • Expectations from a personal trainer
  • Length of planned training
  • Training preferences (individual/group, environment)
  • Client's opinion on suitable services and why
  • Questions or concerns about training services

Important Considerations:

  • Privacy Laws: Ensure your form and data handling comply with the regulation. You'll need a privacy policy outlining how you collect, use, and store personal information.
  • Consumer Protection Laws: Be mindful of fair trading practices and ensure your liability waiver is fair and doesn't attempt to exclude liability for negligence.
  • Professional Indemnity Insurance: Having adequate insurance is crucial for your protection.
  • Legal Advice: It's always recommended to have your intake form and liability waiver reviewed by a legal professional, to ensure they comply with all local laws and regulations and adequately protect your business.

In summary, prioritize the health history, emergency contact information, and client agreement/consent sections as absolutely mandatory. The "highly recommended" questions are crucial for providing effective and safe training. The remaining questions contribute to a more personalized service. Always err on the side of gathering more relevant information, while being mindful of privacy and the client's time.


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