Personal Programming Intake form Name * First Name Last Name Email * Age * Gender Phone (###) ### #### Do you work? If so, what is your job? Client Background Are you physically active? If so, please tell me about it. What are your top 3 fitness or movement goals right now? Why is achieving these goals important to you? What types of workouts do you enjoy most (e.g., strength training, running, circuit training, HIIT, yoga, etc.)? Do you have a specific event, timeline, or milestone you’re working toward? What types of movement or exercises do you dislike or want to avoid? Do you have any current injuries, limitations, or chronic conditions I should be aware of? How much time do you have available for each workout session? Where will you be working out? (gym? if at home, list equipment) How often would you like check-ins or feedback? (Weekly / Biweekly / Other) I hereby confirm that, to the best of my knowledge, the provided information is true and accurate. Please type your first and last name here in place of a signature. Book your Initial consultation!
