First Name
Last Name
Date of Birth
Gender
Phone Number
Email Address
Street Address
City
State/Province
Postal/Zip Code
First Name
Last Name
Phone Number
Relationship
What are your primary fitness goals? (Check all that apply)
Weight loss
Muscle Building
Improved Cardiovascular Health
Increased Flexibility/Mobility
Stress Reduction
Injury Rehabilitation
Sports Performance Enhancement
General Fitness Maintenance
Other:
What is your preferred type of training?
Individual Coaching
Group Coaching
Online Coaching
In-Person Coaching
Hybrid (Online + In-Person)
What is your preferred training schedule?
Morning
Afternoon
Evening
Flexible
Do you have any experience with fitness training?
Beginner
Intermediate
Advanced
Professional Athlete
What types of exercise do you enjoy? (Check all that apply)
Strength Training
Cardio (Running, Cycling, etc.)
Yoga/Pilates
Dance/Zumba
Martial Arts
Functional Training
Outdoor Activities (Hiking, Swimming, etc.)
Other:
Do you have any medical conditions or injuries that may affect your ability to exercise?
Are you currently taking any medications?
Have you ever had surgery or been hospitalized for a medical condition?
Do you have any allergies or dietary restrictions?
Do you smoke or use tobacco products?
Do you consume alcohol?
How would you rate your current stress levels?
Low
Moderate
High
How many hours of sleep do you get per night on average?
Less than 5 hours
5-7 hours
7-9 hours
More than 9 hours
What is your current occupation?
How many hours per day do you spend sitting?
Less than 4 hours
4-8 hours
More than 8 hours
How often do you exercise per week?
Never
1-2 times
3-4 times
5 or more times
What is your typical daily activity level?
Sedentary (Little to no exercise)
Lightly Active (Light exercise 1-3 days/week)
Moderately Active (Moderate exercise 3-5 days/week)
Very Active (Hard exercise 6-7 days/week)
Do you follow a specific diet?
No
Vegetarian
Vegan
Keto
Paleo
Gluten-Free
Other:
How much water do you drink daily?
Less than 1 liter
1-2 liters
2-3 liters
More than 3 liters
What type of coaching are you interested in? (Check all that apply)
Personal Training (1-on-1)
Small Group Training (2-5 people)
Large Group Classes (6+ people)
Online Coaching
Movement and Mobility Training
Nutrition Coaching
Wellness and Lifestyle Coaching
Other:
What is your preferred session duration?
30 minutes
45 minutes
60 minutes
90 minutes
Do you have access to a gym or fitness equipment at home?
What is your budget for fitness coaching?
$50.00−$100.00/month
$100.00−$200.00/month
$200.00−$300.00/month
$300.00+/month
How did you hear about us?
Social Media
Friend/Family Referral
Online Search
Advertisement
Other:
Do you have any specific preferences or requirements for your coach?
Male Coach
Female Coach
No Preference
Other:
What is your primary motivation for starting fitness training?
What challenges do you anticipate in achieving your fitness goals?
How committed are you to following a structured fitness program?
Very Committed
Somewhat Committed
Not Sure
What is your desired timeline for achieving your goals?
1-3 months
3-6 months
6-12 months
12+ months
Do you have any questions or concerns about the services being offered?
I understand that the information provided in this form will be used to create a personalized fitness program tailored to my needs and goals.
I acknowledge that I should consult with a healthcare professional before starting any new fitness program, especially if I have any medical conditions or concerns.
I understand that results may vary based on individual effort, consistency, and adherence to the program.
Client Signature:
Client Intake Form Insights
Please remove this client intake form insights section before publishing.
This Form is a comprehensive tool designed to gather critical information about a client’s health, fitness goals, lifestyle, and preferences. This form ensures that the trainer or coach can create a safe, effective, and personalized program tailored to the client’s needs. Below is a detailed breakdown of each section and its purpose:
This section collects basic demographic and contact details, which are essential for communication and record-keeping. It also includes emergency contact information to ensure the client’s safety during training sessions.
This section identifies the client’s primary fitness objectives and preferences, such as the type of training they enjoy and their experience level.
This section gathers information about the client’s medical conditions, injuries, medications, and lifestyle habits (e.g., smoking, alcohol consumption, sleep patterns).
This section explores the client’s daily routine, activity level, diet, and hydration habits.
This section delves into the client’s preferences for coaching style, session duration, budget, and access to equipment.
This section assesses the client’s motivation, anticipated challenges, and commitment level.
This section includes legal and ethical disclaimers to protect both the client and the trainer.
This intake form is a vital tool for both trainers and clients. It ensures that the training program is safe, effective, and aligned with the client’s goals and preferences. By gathering detailed information upfront, trainers can provide a higher level of service and support, leading to better outcomes for the client.