New Client Intake FormPlease enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Name *FirstLastEmail *BodyweightPlease specify if in kilograms or poundsHeightPlease specify if in centimeters or inchesAgeGenderMaleFemaleOtherTrainingWhat are your short term goals? *These goals are usually more focused and specific, acting as stepping stones towards larger ambitions.What are your long term goals *Long-term goals generally occur over several months to years. These goals are broader and are often the overarching objectives that short-term goals help to gradually achieve. Squat e1RMIf you're unsure, that's okay! We will figure it out as we learn more about you.Bench Press e1RMDeadlift e1RMPlease describe your most recent training or workout program to the best of your abilitiesWhich is your preferred deadlift style?SumoConventionalHow many days a week would you like to train? *1234567Please provide your preferred training daysMondayTuesdayWednesdayThursdayFridaySaturdaySundaySelect all that applyWhen is your competition?MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Skip this question if you do not have a meet plannedWhat equipment do you have access to? This question ensures you're given a program you can adhere to based on available equipment.Do you have any injuries or limitations? Stress and RecoveryHow many hours of sleep do you get each night?5 or less5-66-77-89+Are you interested in nutrition coaching? *YesNoNutrition coaching is available as an add-on service for $75/month. Please describe your current goals and your experience with tracking macros.What have you tried in the past to change your health and eating habits? Did it work?What do you expect from me as your coach?Is there anything else your coach should know about?Coaching Service *Monthly - $225.006 Month - $1,290.00Annual - $2,460.00Training and Nutrition Coaching *Monthly - $300.006-Month - $1,740.0012-Month - $3,300.00Submit
