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Intake Form

Intake Form

Intake form that needs to be filled in upon arrival.

  • Download this form, fill it in and email it back to me to apply for coaching. .
  • You can use either the imperial or metric system to fill in this form. Just state which unit you used (e.g. cm, kg, lb, inch).
Strength level - State your current maximum abilities in weight times reps, e.g. 250 lb x 6 (leave b
Which of the following options best describes your dedication level?
Choose an option
A: Sustainability is most important to me. As long as I’m moving in the right direction, I don’t car
B: I want to strike a reasonable balance between good results in proportion to effort and sustainabi
C: I will do whatever it takes to achieve maximum results without compromising my health.
Misc. What is your occupation?
What is your occupation? You may be general here, e.g. manager/personal trainer/IT/doctor. The aim
Please list any pathologies and injuries (disabilities, allergies, illnesses, syndromes, disorders e
Do you insist on any special diet (e.g. ketogenic, vegan)?


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